Provider Demographics
NPI:1497062046
Name:ST. PETER'S HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:ST. PETER'S HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DOLORES
Authorized Official - Last Name:BAYANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-231-2135
Mailing Address - Street 1:16501 SHERMAN WAY STE 215
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3757
Mailing Address - Country:US
Mailing Address - Phone:818-394-9535
Mailing Address - Fax:818-479-0472
Practice Address - Street 1:16501 SHERMAN WAY STE 215
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3757
Practice Address - Country:US
Practice Address - Phone:818-231-2135
Practice Address - Fax:818-479-0472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based