Provider Demographics
NPI:1285979823
Name:CATTLEYA HOSPICE CARE
Entity type:Organization
Organization Name:CATTLEYA HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILOU
Authorized Official - Middle Name:
Authorized Official - Last Name:PULANCO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-214-1860
Mailing Address - Street 1:750 TERRADO PLZ
Mailing Address - Street 2:SUITE 239
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-3419
Mailing Address - Country:US
Mailing Address - Phone:909-214-1860
Mailing Address - Fax:
Practice Address - Street 1:750 TERRADO PLZ
Practice Address - Street 2:SUITE 239
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3419
Practice Address - Country:US
Practice Address - Phone:909-214-1860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-08
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC3507575OtherCORPORATION #
CAC3507575OtherCORPORATION #