Provider Demographics
NPI:1013534619
Name:SMILING HEARTS HOSPICE, LLC
Entity Type:Organization
Organization Name:SMILING HEARTS HOSPICE, LLC
Other - Org Name:BLUE MONARCH HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AKOBUNDU
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:646-463-4847
Mailing Address - Street 1:7220 TRADE ST STE 245
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2324
Mailing Address - Country:US
Mailing Address - Phone:858-327-3033
Mailing Address - Fax:858-327-3998
Practice Address - Street 1:7220 TRADE ST STE 245
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2324
Practice Address - Country:US
Practice Address - Phone:858-327-3033
Practice Address - Fax:858-327-3998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based