Provider Demographics
NPI:1831618040
Name:ABBOT HOSPICE INC
Entity type:Organization
Organization Name:ABBOT HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-476-8124
Mailing Address - Street 1:11010 ARROW RTE STE 102
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4827
Mailing Address - Country:US
Mailing Address - Phone:909-476-8124
Mailing Address - Fax:267-937-6246
Practice Address - Street 1:11010 ARROW RTE STE 102
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4827
Practice Address - Country:US
Practice Address - Phone:909-476-8124
Practice Address - Fax:267-937-6246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based