Provider Demographics
NPI:1134509821
Name:HOSPICE OF THE NORTH COAST
Entity Type:Organization
Organization Name:HOSPICE OF THE NORTH COAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN CHPN
Authorized Official - Phone:760-431-4100
Mailing Address - Street 1:2525 PIO PICO DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1568
Mailing Address - Country:US
Mailing Address - Phone:760-431-4100
Mailing Address - Fax:760-431-4133
Practice Address - Street 1:2525 PIO PICO DR
Practice Address - Street 2:SUITE 301
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1568
Practice Address - Country:US
Practice Address - Phone:760-431-4100
Practice Address - Fax:760-431-4133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA080000621251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based