Provider Demographics
NPI:1568131092
Name:VIDAS HOSPICE & SENIOR CARE SERVICES INC
Entity Type:Organization
Organization Name:VIDAS HOSPICE & SENIOR CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:F
Authorized Official - Last Name:SHOWAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-415-8216
Mailing Address - Street 1:146 SUN VILLA CT STE A
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-5851
Mailing Address - Country:US
Mailing Address - Phone:760-415-8216
Mailing Address - Fax:
Practice Address - Street 1:146 SUN VILLA CT STE A
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-5851
Practice Address - Country:US
Practice Address - Phone:760-415-8216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based