Provider Demographics
NPI:1467866772
Name:GRACEFUL CARE HOSPICE, INC.
Entity Type:Organization
Organization Name:GRACEFUL CARE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:CLAUNA
Authorized Official - Last Name:WITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-499-3700
Mailing Address - Street 1:2082 NEWBURY RD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-3329
Mailing Address - Country:US
Mailing Address - Phone:805-499-3700
Mailing Address - Fax:805-233-7161
Practice Address - Street 1:2082 NEWBURY RD
Practice Address - Street 2:SUITE 12
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-3329
Practice Address - Country:US
Practice Address - Phone:805-499-3700
Practice Address - Fax:805-233-7161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based