Provider Demographics
NPI:1366064354
Name:ANCHOR HOSPICE INC
Entity type:Organization
Organization Name:ANCHOR HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DICHOSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-294-3825
Mailing Address - Street 1:400 N MOUNTAIN AVE STE 123E
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5176
Mailing Address - Country:US
Mailing Address - Phone:909-294-3825
Mailing Address - Fax:909-294-3439
Practice Address - Street 1:400 N MOUNTAIN AVE STE 123E
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5176
Practice Address - Country:US
Practice Address - Phone:909-294-3825
Practice Address - Fax:909-294-3439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based