Provider Demographics
NPI:1427636760
Name:EXCEPTIONAL HOSPICE CARE
Entity type:Organization
Organization Name:EXCEPTIONAL HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:SENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-256-4564
Mailing Address - Street 1:818 N MOUNTAIN AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4164
Mailing Address - Country:US
Mailing Address - Phone:909-256-4564
Mailing Address - Fax:
Practice Address - Street 1:818 N MOUNTAIN AVE STE 103
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4164
Practice Address - Country:US
Practice Address - Phone:909-256-4564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based