Provider Demographics
NPI:1376817064
Name:FLORENCE HOSPICE CARE INCORPORATION
Entity Type:Organization
Organization Name:FLORENCE HOSPICE CARE INCORPORATION
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 1:433 W ALLEN AVE
Mailing Address - Street 2:UNIT 117
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-4706
Mailing Address - Country:US
Mailing Address - Phone:626-387-7703
Mailing Address - Fax:626-387-7709
Practice Address - Street 1:433 W ALLEN AVE
Practice Address - Street 2:UNIT 117
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-4706
Practice Address - Country:US
Practice Address - Phone:626-387-7703
Practice Address - Fax:626-387-7709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based