Healthcare Provider Details

I. General information

NPI: 1891778999
Provider Name (Legal Business Name): ANGELCARE HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17806 PIONEER BLVD SUITE 105
ARTESIA CA
90701-3971
US

IV. Provider business mailing address

17806 PIONEER BLVD 105
ARTESIA CA
90701-3971
US

V. Phone/Fax

Practice location:
  • Phone: 562-809-1143
  • Fax: 562-809-4922
Mailing address:
  • Phone: 562-809-1143
  • Fax: 562-809-4922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: MISS VIRGIE V ACOSTA
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 562-809-1143