Provider Demographics
NPI:1437701646
Name:PRISTINE HOSPICE AND PALLIATIVE CARE
Entity Type:Organization
Organization Name:PRISTINE HOSPICE AND PALLIATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELISARIO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:714-603-7451
Mailing Address - Street 1:800 S BROOKHURST ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-4301
Mailing Address - Country:US
Mailing Address - Phone:714-603-7451
Mailing Address - Fax:
Practice Address - Street 1:800 S BROOKHURST ST STE 3A
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-4301
Practice Address - Country:US
Practice Address - Phone:714-603-7451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based