MEDICARE: PERPETUAL CARE HOSPICE, INC.

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		CA

General Provider Information

NPI Number	:	1710392402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERPETUAL CARE HOSPICE, INC.

Provider Business Mailing Address
First Line	:	1985 YOSEMITE AVE STE 250
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-5200
Country	:	US
Telephone Number	:	58-583-1070
Fax Number	:	805-583-1071

Provider Business Practice Location Address
First Line	:	1985 YOSEMITE AVE STE 250
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-5200
Country	:	US
Telephone Number	:	805-583-1070
Fax Number	:	805-583-1071

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ARLENE BUELA
Credential	:
Telephone Number	:	805-583-1070

Provider Enumeration Date	:	06/22/2014
Last Update Date	:	08/24/2020

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