Provider Demographics
NPI:1457020091
Name:CRESENCIA HOSPICE CARE
Entity Type:Organization
Organization Name:CRESENCIA HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO/CFO
Authorized Official - Prefix:
Authorized Official - First Name:RESTITUTO
Authorized Official - Middle Name:LUMBA
Authorized Official - Last Name:CALILUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-906-6046
Mailing Address - Street 1:1122 E LINCOLN AVE STE B400
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-1947
Mailing Address - Country:US
Mailing Address - Phone:714-906-6046
Mailing Address - Fax:951-547-1369
Practice Address - Street 1:1122 E LINCOLN AVE STE B400
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-1947
Practice Address - Country:US
Practice Address - Phone:714-906-6046
Practice Address - Fax:951-547-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based