Provider Demographics
NPI:1164855458
Name:HOLLYWOOD HOSPICE CARE INC.
Entity Type:Organization
Organization Name:HOLLYWOOD HOSPICE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTACT PERSON
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-828-5658
Mailing Address - Street 1:11161 CRENSHAW BLVD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90303-2336
Mailing Address - Country:US
Mailing Address - Phone:323-828-5658
Mailing Address - Fax:
Practice Address - Street 1:11161 CRENSHAW BLVD
Practice Address - Street 2:SUITE 180
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90303-2336
Practice Address - Country:US
Practice Address - Phone:323-828-5658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based