Provider Demographics
NPI:1548645302
Name:AFFECTIVE HOSPICE CARE, INC.
Entity type:Organization
Organization Name:AFFECTIVE HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:IVAN
Authorized Official - Last Name:FELIPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-962-7488
Mailing Address - Street 1:5050 PALO VERDE ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2329
Mailing Address - Country:US
Mailing Address - Phone:909-962-7488
Mailing Address - Fax:909-962-7322
Practice Address - Street 1:5050 PALO VERDE ST
Practice Address - Street 2:SUITE 208
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2329
Practice Address - Country:US
Practice Address - Phone:909-962-7488
Practice Address - Fax:909-962-7322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based