Provider Demographics
NPI:1407474679
Name:RECONNECT HOSPICE INC.
Entity Type:Organization
Organization Name:RECONNECT HOSPICE INC.
Other - Org Name:RECONNECT HOSPICE INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:NANAO
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:747-264-1732
Mailing Address - Street 1:14827 VENTURA BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5224
Mailing Address - Country:US
Mailing Address - Phone:818-640-6497
Mailing Address - Fax:818-484-3155
Practice Address - Street 1:14827 VENTURA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5224
Practice Address - Country:US
Practice Address - Phone:747-264-1732
Practice Address - Fax:747-264-1764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based