Organization
SAN BERNARDINO HOSPICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESIREE BRADFORD (CEO/PRESIDENT)
(951) 310-8367
Entity
Organization
Contact information
Practice address
13139 CENTRAL AVE, SUITE E, CHINO, CA 91710-4126
(951) 310-8367
(909) 628-4665
Mailing address
13139 CENTRAL AVE, SUITE E, CHINO, CA 91710-4126
(951) 310-8367
(909) 628-4665
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550002550
CDPH HOSPICE LICENSE
CA
Enumeration date
07/10/2013
Last updated
10/12/2016
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