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General NPI Number Information
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NPI Number | 1609450543
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Entity Type | Organization
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Legal Business Name | HOSPICE OF GREEN PASTURE INC.
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Dates
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Enumeration Date | 05/06/2021
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 860 E LA HABRA BLVD STE 250A
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City | LA HABRA
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State | CA
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Zip | 90631-0815
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Country | US
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Telephone | 562-689-8727
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Fax | 714-459-8989
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Provider Business Mailing Address
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Address Line | 860 E LA HABRA BLVD STE 250A
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City | LA HABRA
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State | CA
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Zip | 90631-0815
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Country | US
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Telephone | 562-689-8727
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Fax | 714-459-8989
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Authorized Official
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Title or Position | CEO
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Name | AUDREY K KO
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Credential | RN
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Telephone | 562-689-8727
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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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