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General NPI Number Information
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NPI Number | 1184014169
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Entity Type | Organization
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Legal Business Name | GRANDCARE HOSPICE SERVICES LLC
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 2555 E COLORADO BLVD SUITE 400-B
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City | PASADENA
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State | CA
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Zip | 91107-6622
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Country | US
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Telephone | 877-889-8570
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Fax | 855-897-7785
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Provider Business Mailing Address
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Address Line | 2555 E COLORADO BLVD SUITE 400-B
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City | PASADENA
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State | CA
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Zip | 91107-6622
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Country | US
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Telephone | 877-889-8570
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Fax | 855-897-7785
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SHANNON JONES
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Credential | RN
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Telephone | 877-889-8570
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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 | 550001379
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License Number State | CA
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