Table # Values
licensed_healthcare_facility_listing 4 period: 2020-12-31
oshpd_id: 406362890
facility_name: FAITH KAY HOSPICE, LLC
license_num: 550005714
facility_level_desc: Parent Facility
dba_address1: 4959 Palo Verde St
dba_city: Montclair
dba_zip_code: 91763
county_code: 36
county_name: San Bernardino
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2020-08-11
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.08091000
longitude: -117.69677000

period: 2021-12-31
oshpd_id: 406362890
facility_name: FAITH KAY HOSPICE, LLC
license_num: 550005714
facility_level_desc: Parent Facility
dba_address1: 4959 Palo Verde St
dba_city: Montclair
dba_zip_code: 91763
county_code: 36
county_name: San Bernardino
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2020-08-11
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.08091000
longitude: -117.69677000

period: 2022-12-31
oshpd_id: 406362890
facility_name: FAITH KAY HOSPICE, LLC
license_num: 550005714
facility_level_desc: Parent Facility
dba_address1: 4959 Palo Verde St
dba_city: Montclair
dba_zip_code: 91763
county_code: 36
county_name: San Bernardino
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2020-08-11
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.08091000
longitude: -117.69677000

period: 2021-06-30
oshpd_id: 406362890
facility_name: FAITH KAY HOSPICE, LLC
license_num: 550005714
facility_level_desc: Parent Facility
dba_address1: 4959 Palo Verde St
dba_city: Montclair
dba_zip_code: 91763
county_code: 36
county_name: San Bernardino
er_service_level_desc: Not Applicable
total_number_beds: None
facility_status_desc: Open
facility_status_date: 2020-08-11
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.08091000
longitude: -117.69677000