=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396168563
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLESSED HOSPICE & PALLIATIVE CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2014
-----------------------------------------------------
Last Update Date | 08/14/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 770 S BREA BOULEVARD SUITE 211
-----------------------------------------------------
City | BREA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92821-5312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-671-9533
-----------------------------------------------------
Fax | 714-671-9534
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 770 S BREA BOULEVARD SUITE 211
-----------------------------------------------------
City | BREA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92821-5312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-671-9533
-----------------------------------------------------
Fax | 714-671-9534
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | KENNETH HARRINGTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 714-671-9533
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------