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General NPI Number Information
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NPI Number | 1770539256
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Entity Type | Organization
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Legal Business Name | NEW HAVEN HOSPICE CARE, INC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 02/18/2019
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Provider Practice Location Address
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Address Line | 1700 E. LINCOLN AVE #202
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City | ANAHEIM
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State | CA
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Zip | 92805-4323
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Country | US
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Telephone | 714-774-2498
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Fax | 714-774-2485
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Provider Business Mailing Address
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Address Line | 1700 E. LINCOLN AVE #202
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City | ANAHEIM
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State | CA
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Zip | 92805-4323
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Country | US
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Telephone | 714-774-2498
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Fax | 714-774-2485
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | PROCOPIO T. MISA
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Credential |
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Telephone | 714-774-2498
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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 | 080000792
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License Number State | CA
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