Healthcare Provider Details

I. General information

NPI: 1407452634
Provider Name (Legal Business Name): OHANA HOSPICE AND PALLIATIVE CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2020
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date: 02/07/2022
Reactivation Date: 08/30/2022

III. Provider practice location address

5775 E LOS ANGELES AVE STE 212
SIMI VALLEY CA
93063-5215
US

IV. Provider business mailing address

5775 E LOS ANGELES AVE STE 212
SIMI VALLEY CA
93063-5215
US

V. Phone/Fax

Practice location:
  • Phone: 818-922-2777
  • Fax: 818-688-0268
Mailing address:
  • Phone: 818-922-2777
  • Fax: 818-688-0268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: MARY GRACE BADONG
Title or Position: CEO
Credential:
Phone: 818-922-2777