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General NPI Number Information
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NPI Number | 1962667600
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Entity Type | Organization
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Legal Business Name | SACRED HEART HOSPICE, INC.
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 08/21/2008
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Provider Practice Location Address
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Address Line | 3731 WILSHIRE BLVD STE 618
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City | LOS ANGELES
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State | CA
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Zip | 90010-2876
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Country | US
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Telephone | 213-385-4247
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Fax | 213-385-4238
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Provider Business Mailing Address
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Address Line | 3731 WILSHIRE BLVD STE 618
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City | LOS ANGELES
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State | CA
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Zip | 90010-2876
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Country | US
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Telephone | 213-385-4247
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Fax | 213-385-4238
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Authorized Official
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Title or Position | EXEC. DIRECTOR
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Name | MS. LIZA G CORDERO
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Credential |
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Telephone | 213-385-4247
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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 | 550000246
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License Number State | CA
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