Provider Demographics
NPI:1073273850
Name:VIDA CARE HOSPICE SERVICES, LLC
Entity Type:Organization
Organization Name:VIDA CARE HOSPICE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA ELENA
Authorized Official - Middle Name:G
Authorized Official - Last Name:RECINOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-270-7588
Mailing Address - Street 1:5100 N 6TH ST STE 111
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7506
Mailing Address - Country:US
Mailing Address - Phone:559-270-7588
Mailing Address - Fax:
Practice Address - Street 1:5100 N 6TH ST STE 111
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7506
Practice Address - Country:US
Practice Address - Phone:559-707-5882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based