Provider Demographics
NPI:1639484678
Name:GRACEFUL PALMS HOSPICE AND PALLIATIVE CARE CORP
Entity Type:Organization
Organization Name:GRACEFUL PALMS HOSPICE AND PALLIATIVE CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:JAQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARABIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-538-1435
Mailing Address - Street 1:38700 5TH ST W STE G
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3996
Mailing Address - Country:US
Mailing Address - Phone:661-538-1435
Mailing Address - Fax:661-538-0956
Practice Address - Street 1:38700 5TH ST W STE G
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3996
Practice Address - Country:US
Practice Address - Phone:661-538-1435
Practice Address - Fax:661-538-0956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-14
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1639484678251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based