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General NPI Number Information
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NPI Number | 1134768138
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Entity Type | Organization
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Legal Business Name | INFINITE HEART HOSPICE LLC
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Dates
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Enumeration Date | 12/23/2019
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Last Update Date | 02/11/2020
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Provider Practice Location Address
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Address Line | 500 S CHINOWTH ST STE B
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City | VISALIA
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State | CA
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Zip | 93277-1653
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Country | US
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Telephone | 559-409-7500
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Fax | 559-409-7501
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Provider Business Mailing Address
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Address Line | PO BOX 670
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City | PISMO BEACH
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State | CA
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Zip | 93448-0670
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Country | US
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Telephone | 661-205-3666
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Fax |
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Authorized Official
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Title or Position | COO/ADMINSTRATOR
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Name | STACEY HARRIS
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Credential |
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Telephone | 661-205-3666
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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 |
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License Number State |
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