Provider Demographics
NPI:1578840260
Name:ST JOSEPH HEALTH SYSTEM HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:ST JOSEPH HEALTH SYSTEM HOME CARE SERVICES LLC
Other - Org Name:PROVIDENCE HOSPICE ORANGE COUNTY SOUTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY FOR ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-525-5392
Mailing Address - Street 1:3345 MICHELSON DR STE 310
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-7676
Mailing Address - Country:US
Mailing Address - Phone:714-975-8026
Mailing Address - Fax:714-975-8027
Practice Address - Street 1:3345 MICHELSON DR STE 310
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-7676
Practice Address - Country:US
Practice Address - Phone:714-975-8026
Practice Address - Fax:714-975-8027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based