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General NPI Number Information
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NPI Number | 1821652678
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Entity Type | Organization
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Legal Business Name | RISING SUN HOSPICE, LLC
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Dates
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Enumeration Date | 04/26/2019
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Last Update Date | 04/26/2019
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Provider Practice Location Address
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Address Line | 8700 RESEDA BLVD STE 218
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4087
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Country | US
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Telephone | 818-527-1108
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Fax | 818-527-1186
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Provider Business Mailing Address
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Address Line | 8700 RESEDA BLVD STE 218
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4087
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Country | US
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Telephone | 818-527-1108
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Fax | 818-527-1186
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CONCHITA O DIATA
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Credential |
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Telephone | 760-770-1244
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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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