Provider Demographics
NPI:1457867236
Name:RADIANT CARE HOSPICE LLC
Entity Type:Organization
Organization Name:RADIANT CARE HOSPICE LLC
Other - Org Name:RADIANT CARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:NASIR
Authorized Official - Last Name:WARRIACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-610-4153
Mailing Address - Street 1:1740 MARCO POLO WAY STE 14
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-4500
Mailing Address - Country:US
Mailing Address - Phone:408-707-5622
Mailing Address - Fax:
Practice Address - Street 1:1740 MARCO POLO WAY STE 14
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4500
Practice Address - Country:US
Practice Address - Phone:408-707-5622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-16
Last Update Date:2017-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health