Provider Demographics
NPI:1114292133
Name:ARCADIA HOSPICE PROVIDER, INC.
Entity Type:Organization
Organization Name:ARCADIA HOSPICE PROVIDER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:ALMUETE
Authorized Official - Last Name:ANTENOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-254-0101
Mailing Address - Street 1:159 E HUNTINGTON DR STE 3
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-7057
Mailing Address - Country:US
Mailing Address - Phone:626-254-0101
Mailing Address - Fax:626-254-0401
Practice Address - Street 1:159 E HUNTINGTON DR STE 3
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-7057
Practice Address - Country:US
Practice Address - Phone:626-254-0101
Practice Address - Fax:626-254-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based