Table # Values
licensed_healthcare_facility_listing 4 period: current
oshpd_id: 406365167
facility_name: PRIMERICARE HOSPICE LLC
license_num: 550007583
facility_level_desc: Parent Facility
dba_address1: 222 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: 2021-12-18
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09627420
longitude: -117.66965610

period: 2022-12-31
oshpd_id: 406365167
facility_name: PRIMERICARE HOSPICE LLC
license_num: 550007583
facility_level_desc: Parent Facility
dba_address1: 222 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: 2021-12-18
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09640000
longitude: -117.66959000

period: 2022-06-30
oshpd_id: 406365167
facility_name: PRIMERICARE HOSPICE LLC
license_num: 550007583
facility_level_desc: Parent Facility
dba_address1: 222 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: 2021-12-18
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09640000
longitude: -117.66959000

period: 2023-06-30
oshpd_id: 406365167
facility_name: PRIMERICARE HOSPICE LLC
license_num: 550007583
facility_level_desc: Parent Facility
dba_address1: 222 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: 2021-12-18
license_type_desc: Home Health Agency/Hospice
license_category_desc: Hospice
latitude: 34.09640000
longitude: -117.66959000