Provider Demographics
NPI:1639592314
Name:KAMELYA HOSPICE
Entity Type:Organization
Organization Name:KAMELYA HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC VP
Authorized Official - Prefix:MR
Authorized Official - First Name:RODEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:AGPAOA
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:619-733-7818
Mailing Address - Street 1:3835 AVOCADO BLVD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-8525
Mailing Address - Country:US
Mailing Address - Phone:619-733-7818
Mailing Address - Fax:619-599-8072
Practice Address - Street 1:7642 NORTH AVE
Practice Address - Street 2:
Practice Address - City:LEMON GROVE
Practice Address - State:CA
Practice Address - Zip Code:91945-1628
Practice Address - Country:US
Practice Address - Phone:619-733-7818
Practice Address - Fax:619-599-8072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based