MEDICARE: BLESSED JOURNEY HOSPICE, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1063013720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESSED JOURNEY HOSPICE, LLC.

Provider Business Mailing Address
First Line	:	9778 KATELLA AVE STE 111
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-6446
Country	:	US
Telephone Number	:	714-782-3295
Fax Number	:	714-551-9065

Provider Business Practice Location Address
First Line	:	9778 KATELLA AVE STE 111
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-6446
Country	:	US
Telephone Number	:	714-782-3295
Fax Number	:	714-551-9065

Authorized Official
Title or Position	:	DPCS DESIGNEE
Name	:	LEONORA BORJA
Credential	:	RN
Telephone Number	:	909-538-0732

Provider Enumeration Date	:	11/07/2020
Last Update Date	:	11/07/2020

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