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General NPI Number Information
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NPI Number | 1326475930
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Entity Type | Organization
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Legal Business Name | CHATEAU D'LUMINA HOSPICE AND PALLIATIVE CARE, INC
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Dates
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Enumeration Date | 09/27/2013
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 711 E WALNUT ST STE 203
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City | PASADENA
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State | CA
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Zip | 91101-1676
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Country | US
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Telephone | 626-792-3100
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Fax | 626-792-3101
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Provider Business Mailing Address
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Address Line | 711 E WALNUT ST STE 203
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City | PASADENA
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State | CA
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Zip | 91101-1676
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Country | US
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Telephone | 626-792-3100
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Fax | 626-792-3101
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | SOPHIA SHAKLIAN
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Credential |
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Telephone | 626-792-3100
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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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