Provider Demographics
NPI:1609227875
Name:IDEAL PALLIATIVE AND HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:IDEAL PALLIATIVE AND HOSPICE CARE, INC.
Other - Org Name:IDEAL HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FILOMENO
Authorized Official - Middle Name:EBORA
Authorized Official - Last Name:ALCAIDE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:626-457-8930
Mailing Address - Street 1:420 N MONTEBELLO BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4274
Mailing Address - Country:US
Mailing Address - Phone:323-516-0320
Mailing Address - Fax:626-737-1088
Practice Address - Street 1:420 N MONTEBELLO BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4274
Practice Address - Country:US
Practice Address - Phone:323-516-0320
Practice Address - Fax:626-737-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based