Provider Demographics
NPI:1003415795
Name:ST ROSE HOSPICE CARE INC
Entity Type:Organization
Organization Name:ST ROSE HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-247-3752
Mailing Address - Street 1:14545 FRIAR ST STE 198
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2397
Mailing Address - Country:US
Mailing Address - Phone:747-247-3752
Mailing Address - Fax:747-247-3753
Practice Address - Street 1:14545 FRIAR ST STE 198
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2397
Practice Address - Country:US
Practice Address - Phone:747-247-3752
Practice Address - Fax:747-247-3753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based