Provider Demographics
NPI:1043639107
Name:ART OF HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:ART OF HOSPICE CARE, INC.
Other - Org Name:SOUTHCOAST HOSPICE CARE, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORELIE A
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTONIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-599-9132
Mailing Address - Street 1:7710 BALBOA AVE STE 329
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2269
Mailing Address - Country:US
Mailing Address - Phone:619-756-7096
Mailing Address - Fax:619-487-0218
Practice Address - Street 1:7710 BALBOA AVE STE 329
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111
Practice Address - Country:US
Practice Address - Phone:619-756-7096
Practice Address - Fax:619-487-0218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA75-1634Medicare UPIN