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General NPI Number Information
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NPI Number | 1033661533
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Entity Type | Organization
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Legal Business Name | SOUVENIR HOSPICE AND PALLIATIVE CARE, INC.
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Dates
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Enumeration Date | 10/31/2016
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Last Update Date | 12/12/2017
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Provider Practice Location Address
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Address Line | 1451 RIVER PARK DR STE 222
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City | SACRAMENTO
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State | CA
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Zip | 95815-4521
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Country | US
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Telephone | 844-363-3325
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Fax | 916-914-2134
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Provider Business Mailing Address
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Address Line | 750 ALFRED NOBEL DR STE 204
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City | HERCULES
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State | CA
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Zip | 94547-1836
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Country | US
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Telephone | 844-363-3325
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Fax | 916-914-2134
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Authorized Official
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Title or Position | CEO
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Name | MR. UKEJE ELENDU
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Credential |
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Telephone | 844-363-3325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 550003260
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License Number State | CA
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