Provider Demographics
NPI:1164538765
Name:ADMIRAL HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:ADMIRAL HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOSIE
Authorized Official - Middle Name:AUSTRIA
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MS
Authorized Official - Phone:562-254-6111
Mailing Address - Street 1:4010 WATSON PLAZA DR.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-4000
Mailing Address - Country:US
Mailing Address - Phone:562-429-1500
Mailing Address - Fax:562-429-1599
Practice Address - Street 1:4010 WATSON PLAZA DR.
Practice Address - Street 2:SUITE 120
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-4000
Practice Address - Country:US
Practice Address - Phone:562-429-1500
Practice Address - Fax:562-429-1599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADHS-CA980008682251G00000X
CA550000244251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC51507FMedicaid
551507Medicare Oscar/Certification