Healthcare Provider Details

I. General information

NPI: 1538141841
Provider Name (Legal Business Name): HOSPICE CARE OF THE WEST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 11/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27442 PORTOLA PKWY SUITE 200
FOOTHILL RANCH CA
92610-2823
US

IV. Provider business mailing address

27442 PORTOLA PKWY SUITE 200
FOOTHILL RANCH CA
92610-2823
US

V. Phone/Fax

Practice location:
  • Phone: 949-282-5948
  • Fax: 949-282-5804
Mailing address:
  • Phone: 949-282-5948
  • Fax: 949-282-5804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number080000791
License Number StateCA

VIII. Authorized Official

Name: MR. SCOTT ROBINSON
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential:
Phone: 949-282-5948