Provider Demographics
NPI:1194013110
Name:ANGELS OF THE VALLEY HOSPICE CARE SOUTH BAY
Entity Type:Organization
Organization Name:ANGELS OF THE VALLEY HOSPICE CARE SOUTH BAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROWENA
Authorized Official - Middle Name:I
Authorized Official - Last Name:ARGONZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-402-3639
Mailing Address - Street 1:11911 ARTESIA BLVD
Mailing Address - Street 2:SUITE 104A
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90701-4065
Mailing Address - Country:US
Mailing Address - Phone:562-402-3639
Mailing Address - Fax:562-402-3839
Practice Address - Street 1:11911 ARTESIA BLVD
Practice Address - Street 2:SUITE 104A
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90701-4065
Practice Address - Country:US
Practice Address - Phone:562-402-3639
Practice Address - Fax:562-402-3839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based