Provider Demographics
NPI:1699317388
Name:SAINT LAURA PALLIATIVE AND HOSPICE CARE INC.
Entity type:Organization
Organization Name:SAINT LAURA PALLIATIVE AND HOSPICE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LILIBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAN GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-684-7410
Mailing Address - Street 1:271 E WORKMAN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-3549
Mailing Address - Country:US
Mailing Address - Phone:626-364-7534
Mailing Address - Fax:626-364-7561
Practice Address - Street 1:271 E WORKMAN ST STE 200
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3549
Practice Address - Country:US
Practice Address - Phone:626-364-7534
Practice Address - Fax:626-364-7561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based