Provider Demographics
NPI:1225272834
Name:COMPLETE FAITH PALLIATIVE HOSPICE CARE, INC
Entity Type:Organization
Organization Name:COMPLETE FAITH PALLIATIVE HOSPICE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BLANKENHORN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:562-319-9374
Mailing Address - Street 1:14111 FREEWAY DRIVE
Mailing Address - Street 2:SUITE 318
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-3658
Mailing Address - Country:US
Mailing Address - Phone:562-319-9374
Mailing Address - Fax:951-736-8996
Practice Address - Street 1:14111 FREEWAY DRIVE
Practice Address - Street 2:SUITE 318
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3658
Practice Address - Country:US
Practice Address - Phone:562-319-9374
Practice Address - Fax:951-736-8996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA#217032251G00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based