Eagles Wings Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

EAGLES WINGS HOSPICE, LLC

Practice address

255 N. D Street
Suite 200-Xix
San Bernardino, CA 92401

Phone

(909) 966-4053

Fax

(909) 966-4052

NPI assigned

Sep 9, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Jane De la Cruz

Title

Owner

Phone

(702) 929-0021

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1649885468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 N. D STREET",
            "address_2": "SUITE 200-XIX",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92401",
            "telephone_number": "909-966-4053",
            "fax_number": "909-966-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N. D STREET",
            "address_2": "SUITE 200-XIX",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92401",
            "telephone_number": "909-966-4053",
            "fax_number": "909-966-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLES WINGS HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-05",
        "status": "A",
        "authorized_official_last_name": "DE LA CRUZ",
        "authorized_official_first_name": "MARY JANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-929-0021"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WWW.GMAIL.COM",
            "affiliation": "N",
            "address_1": "255 N. D STREET",
            "address_2": "SUITE 200-XIX",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community Based Hospice Care Agency in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.