Provider Demographics
NPI:1730561085
Name:PRECIOUS LOVE HOSPICE
Entity type:Organization
Organization Name:PRECIOUS LOVE HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAGDALENE
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBOGHIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-897-9002
Mailing Address - Street 1:1807 NORTH D STREET,
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-7731
Mailing Address - Country:US
Mailing Address - Phone:951-221-1687
Mailing Address - Fax:909-494-7772
Practice Address - Street 1:23800 SUNNYMEAD BLVD STE C
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-7731
Practice Address - Country:US
Practice Address - Phone:951-221-1687
Practice Address - Fax:909-494-7772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-23
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based