Table # Values
licensed_healthcare_facility_listing 9 period: current
oshpd_id: 406361596
facility_name: PROVIDENCE HOSPICE INC.
license_num: 550004477
facility_level_desc: Parent Facility
dba_address1: 440 N Mountain Ave
dba_city: Upland
dba_zip_code: 91786
county_code: 36
county_name: San Bernardino
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2018-11-19
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09893740
longitude: -117.66828110

period: 2019-12-31
oshpd_id: 406361596
facility_name: PROVIDENCE HOSPICE INC.
license_num: 550004477
facility_level_desc: Parent Facility
dba_address1: 440 N MOUNTAIN AVE
dba_city: UPLAND
dba_zip_code: 91786
county_code: 36
county_name: SAN BERNARDINO
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2018-11-19
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09893000
longitude: -117.67007000

period: 2020-12-31
oshpd_id: 406361596
facility_name: PROVIDENCE HOSPICE INC.
license_num: 550004477
facility_level_desc: Parent Facility
dba_address1: 440 N Mountain Ave
dba_city: Upland
dba_zip_code: 91786
county_code: 36
county_name: San Bernardino
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2018-11-19
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09893000
longitude: -117.67007000

period: 2021-12-31
oshpd_id: 406361596
facility_name: PROVIDENCE HOSPICE INC.
license_num: 550004477
facility_level_desc: Parent Facility
dba_address1: 440 N Mountain Ave
dba_city: Upland
dba_zip_code: 91786
county_code: 36
county_name: San Bernardino
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2018-11-19
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09893000
longitude: -117.67007000

period: 2022-12-31
oshpd_id: 406361596
facility_name: PROVIDENCE HOSPICE INC.
license_num: 550004477
facility_level_desc: Parent Facility
dba_address1: 440 N Mountain Ave
dba_city: Upland
dba_zip_code: 91786
county_code: 36
county_name: San Bernardino
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2018-11-19
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09893000
longitude: -117.67007000

period: 2020-06-30
oshpd_id: 406361596
facility_name: PROVIDENCE HOSPICE INC.
license_num: 550004477
facility_level_desc: Parent Facility
dba_address1: 440 N Mountain Ave
dba_city: Upland
dba_zip_code: 91786
county_code: 36
county_name: San Bernardino
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2018-11-19
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09893000
longitude: -117.67007000

period: 2021-06-30
oshpd_id: 406361596
facility_name: PROVIDENCE HOSPICE INC.
license_num: 550004477
facility_level_desc: Parent Facility
dba_address1: 440 N Mountain Ave
dba_city: Upland
dba_zip_code: 91786
county_code: 36
county_name: San Bernardino
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2018-11-19
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09893000
longitude: -117.67007000

period: 2022-06-30
oshpd_id: 406361596
facility_name: PROVIDENCE HOSPICE INC.
license_num: 550004477
facility_level_desc: Parent Facility
dba_address1: 440 N Mountain Ave
dba_city: Upland
dba_zip_code: 91786
county_code: 36
county_name: San Bernardino
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2018-11-19
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09893000
longitude: -117.67007000

period: 2023-06-30
oshpd_id: 406361596
facility_name: PROVIDENCE HOSPICE INC.
license_num: 550004477
facility_level_desc: Parent Facility
dba_address1: 440 N Mountain Ave
dba_city: Upland
dba_zip_code: 91786
county_code: 36
county_name: San Bernardino
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2018-11-19
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09893000
longitude: -117.67007000