Provider Demographics
NPI:1114505062
Name:AMERICAN HOSPICE PROVIDER CORPORATION
Entity Type:Organization
Organization Name:AMERICAN HOSPICE PROVIDER CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANCHETA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-787-5782
Mailing Address - Street 1:3160 S VALLEY VIEW BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-8316
Mailing Address - Country:US
Mailing Address - Phone:702-780-5141
Mailing Address - Fax:
Practice Address - Street 1:3160 S VALLEY VIEW BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8316
Practice Address - Country:US
Practice Address - Phone:702-780-5141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based