Provider Demographics
NPI:1053680280
Name:HOLY CROSS HOSPICE, INC.
Entity Type:Organization
Organization Name:HOLY CROSS HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE JUM
Authorized Official - Middle Name:SEGOVIA
Authorized Official - Last Name:CABALINAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-283-6588
Mailing Address - Street 1:28 N OAK AVE
Mailing Address - Street 2:SUITE #201
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-5870
Mailing Address - Country:US
Mailing Address - Phone:626-283-6588
Mailing Address - Fax:626-283-6587
Practice Address - Street 1:28 N OAK AVE
Practice Address - Street 2:SUITE #201
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-5870
Practice Address - Country:US
Practice Address - Phone:626-283-6588
Practice Address - Fax:626-283-6587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
CA550002036251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based