Provider Demographics
NPI:1114508751
Name:JJ HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:JJ HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-666-1276
Mailing Address - Street 1:810 GREENBRIAR AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-5624
Mailing Address - Country:US
Mailing Address - Phone:747-666-1276
Mailing Address - Fax:800-681-1672
Practice Address - Street 1:6320 CANOGA AVE STE 1571
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2526
Practice Address - Country:US
Practice Address - Phone:747-666-1276
Practice Address - Fax:800-681-1672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based