Provider Demographics
NPI:1306271606
Name:GABRIELLE HOSPICE AND PALLIATIVE
Entity type:Organization
Organization Name:GABRIELLE HOSPICE AND PALLIATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BEATRIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRIELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-303-9366
Mailing Address - Street 1:400 N MOUNTAIN AVE STE 123D
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5176
Mailing Address - Country:US
Mailing Address - Phone:909-303-9366
Mailing Address - Fax:909-303-9370
Practice Address - Street 1:400 N MOUNTAIN AVE STE 123D
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5176
Practice Address - Country:US
Practice Address - Phone:909-303-9366
Practice Address - Fax:909-303-9370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3594955251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based