Healthcare Provider Details
I. General information
NPI: 1841517331
Provider Name (Legal Business Name): C@A HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/23/2010
Last Update Date: 02/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 WEST BROADWAY SUITE 1170
GLENDALE CA
91210-1217
US
IV. Provider business mailing address
100 WEST BROADWAY SUITE 1170
GLENDALE CA
91210-1217
US
V. Phone/Fax
- Phone: 818-691-7201
- Fax: 818-301-5012
- Phone: 818-691-7201
- Fax: 818-301-5012
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | 550001614 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ADOLFO
CATBAGAN
Title or Position: CEO/PRESIDENT
Credential:
Phone: 818-691-7201