Provider Demographics
NPI:1669042420
Name:SEASHELL HOSPICE, INC.
Entity Type:Organization
Organization Name:SEASHELL HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BIBI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:657-331-8121
Mailing Address - Street 1:2331 W LINCOLN AVE STE 100L
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5103
Mailing Address - Country:US
Mailing Address - Phone:657-331-8121
Mailing Address - Fax:657-331-8124
Practice Address - Street 1:2331 W LINCOLN AVE STE 100L
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5103
Practice Address - Country:US
Practice Address - Phone:657-331-8121
Practice Address - Fax:657-331-8124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based