Provider Demographics
NPI:1639700081
Name:TRUSTED HOSPICE, INC.
Entity Type:Organization
Organization Name:TRUSTED HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:LYDECKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:805-643-7833
Mailing Address - Street 1:3212 LOMA VISTA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3093
Mailing Address - Country:US
Mailing Address - Phone:805-643-7833
Mailing Address - Fax:
Practice Address - Street 1:3212 LOMA VISTA RD STE 101
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3093
Practice Address - Country:US
Practice Address - Phone:805-643-7833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-03
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based