MEDICARE: GLOWING SMILE HOSPICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1245858646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOWING SMILE HOSPICE

Provider Business Mailing Address
First Line	:	104 W BEVERLY BLVD STE A
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-4305
Country	:	US
Telephone Number	:	747-257-0030
Fax Number	:	747-257-0031

Provider Business Practice Location Address
First Line	:	104 W BEVERLY BLVD STE A
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-4305
Country	:	US
Telephone Number	:	747-257-0030
Fax Number	:	747-257-0031

Authorized Official
Title or Position	:	CEO
Name	:	CLARISSA EMBETH DONES
Credential	:
Telephone Number	:	747-257-0030

Provider Enumeration Date	:	07/12/2020
Last Update Date	:	09/03/2025

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Directions to “GLOWING SMILE HOSPICE ” Practice Location

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