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General NPI Number Information
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NPI Number | 1396156832
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Entity Type | Organization
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Legal Business Name | SUMMER BREEZE HOSPICE AND PALLIATIVE CARE, INC.
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Dates
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Enumeration Date | 05/19/2014
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Last Update Date | 08/07/2021
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Provider Practice Location Address
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Address Line | 609 W BEVERLY BLVD SUITE A
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City | MONTEBELLO
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State | CA
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Zip | 90640-3623
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Country | US
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Telephone | 323-483-5078
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Fax | 323-978-1632
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Provider Business Mailing Address
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Address Line | 609 W BEVERLY BLVD SUITE A
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City | MONTEBELLO
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State | CA
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Zip | 90640-3623
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Country | US
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Telephone | 323-483-5078
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Fax | 323-978-1632
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | WELLINGTON CARLOS JR.
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Credential |
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Telephone | 213-494-8761
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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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