Provider Demographics
NPI:1114949203
Name:VNA HOSPICE AND PALLIATIVE CARE OF SOUTHERN CALIFORNIA
Entity Type:Organization
Organization Name:VNA HOSPICE AND PALLIATIVE CARE OF SOUTHERN CALIFORNIA
Other - Org Name:RIM OF THE WORLD HOME HEALTH, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-624-3574
Mailing Address - Street 1:PO BOX 2230
Mailing Address - Street 2:
Mailing Address - City:LAKE ARROWHEAD
Mailing Address - State:CA
Mailing Address - Zip Code:92352-2230
Mailing Address - Country:US
Mailing Address - Phone:909-336-7781
Mailing Address - Fax:909-337-7770
Practice Address - Street 1:28200 CALIFORNIA 189 #02-240
Practice Address - Street 2:
Practice Address - City:LAKE ARROWHEAD
Practice Address - State:CA
Practice Address - Zip Code:92352-9700
Practice Address - Country:US
Practice Address - Phone:909-336-7781
Practice Address - Fax:909-337-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240000861251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA240000861OtherHOME HEALTH AGENCY
CAHHA08232FMedicaid
CA058420Medicare PIN