St Grace Hospice House, Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ST GRACE HOSPICE HOUSE, INC

Doing business as

Janet's Enterprise

Practice address

1351 5TH Ave
Upland, CA 91786-3311

Phone

(909) 870-5330

Fax

(909) 252-7829

NPI assigned

Jun 23, 2023

Last updated

Jun 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kathleen Janet Haywood, N/A

Title

President

Phone

(951) 545-4462

Specialties & licenses 1

Addresses

Other names 2

• Janet's Enterprise Doing business as
• St Grace Hospice House, Inc Former legal business name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1831875038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1476 W 9TH ST STE B1",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865699",
            "telephone_number": "951-545-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 5TH AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863311",
            "telephone_number": "909-870-5330",
            "fax_number": "909-252-7829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST GRACE HOSPICE HOUSE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "HAYWOOD",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "JANET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-545-4462",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "N/A"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Janet's Enterprise",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Grace Hospice House, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Shatarra Arrionna Spicer
• James Thomas Spillan Jr.
• Thomas Spinosa, DMD
• Scott Thomas Spotswood I
• Shanta Srivastava, MD
• St Grace Manor, Inc
• St. Grace Hospice, Inc.
• Stanley W. Yang, M.D., a Professional Medical Corporation
• Destiny Victoria Starkweather
• Stateside Medical LLC

• Community Based Hospice Care Agency in Upland, CA
• Providers in Upland, 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 Jun 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.