Provider Demographics
NPI:1679241640
Name:PEACEFUL HEART HOSPICE
Entity Type:Organization
Organization Name:PEACEFUL HEART HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-436-2991
Mailing Address - Street 1:22048 SHERMAN WAY STE 207
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1840
Mailing Address - Country:US
Mailing Address - Phone:818-436-2991
Mailing Address - Fax:818-436-2995
Practice Address - Street 1:22048 SHERMAN WAY STE 207
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1840
Practice Address - Country:US
Practice Address - Phone:818-436-2991
Practice Address - Fax:818-436-2995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based