Provider Demographics
NPI:1164014775
Name:NEW ERA HOSPICE LLC
Entity Type:Organization
Organization Name:NEW ERA HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:BUNDALIAN
Authorized Official - Last Name:TEJADA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, RN
Authorized Official - Phone:725-224-2053
Mailing Address - Street 1:3733 VIA CORSO AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-0512
Mailing Address - Country:US
Mailing Address - Phone:725-224-2053
Mailing Address - Fax:
Practice Address - Street 1:730 ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1702
Practice Address - Country:US
Practice Address - Phone:702-224-2053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based