Healthcare Provider Details

I. General information

NPI: 1255730115
Provider Name (Legal Business Name): LA CARE HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2014
Last Update Date: 08/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

596 N LAKE AVE 2ND FLOOR
PASADENA CA
91101-1455
US

IV. Provider business mailing address

596 N LAKE AVE 2ND FLOOR
PASADENA CA
91101-1455
US

V. Phone/Fax

Practice location:
  • Phone: 626-818-6456
  • Fax:
Mailing address:
  • Phone: 626-818-6456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GINA CASTROMAYOR
Title or Position: PRESIDENT
Credential:
Phone: 626-818-6456