Provider Demographics
NPI:1295364909
Name:GOLDEN STANDARD HOSPICE
Entity Type:Organization
Organization Name:GOLDEN STANDARD HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPCS
Authorized Official - Prefix:
Authorized Official - First Name:MARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAREAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:805-823-5901
Mailing Address - Street 1:2229 KNOLLHAVEN ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2526
Mailing Address - Country:US
Mailing Address - Phone:805-823-5901
Mailing Address - Fax:
Practice Address - Street 1:1400 EASTON DR STE 147B
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-9406
Practice Address - Country:US
Practice Address - Phone:805-823-5901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-04
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based