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General NPI Number Information
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NPI Number | 1215366604
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Entity Type | Organization
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Legal Business Name | JMT HOSPICE INC.
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Dates
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Enumeration Date | 11/05/2013
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Last Update Date | 12/09/2013
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Provider Practice Location Address
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Address Line | 2082 NEWBURY RD SUITE 8
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City | NEWBURY PARK
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State | CA
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Zip | 91320-3329
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Country | US
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Telephone | 805-744-8010
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Fax | 805-262-6294
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Provider Business Mailing Address
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Address Line | 2082 NEWBURY RD SUITE 8
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City | NEWBURY PARK
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State | CA
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Zip | 91320-3329
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Country | US
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Telephone | 805-744-8010
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Fax | 805-262-6294
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Authorized Official
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Title or Position | CEO
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Name | MRS. VIRGINIA C WITT
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Credential |
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Telephone | 805-341-0464
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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 | C3599130
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License Number State | CA
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