Provider Demographics
NPI:1679860274
Name:EVE HOSPICE, INC.
Entity Type:Organization
Organization Name:EVE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GUILBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DELA FUENTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-893-8883
Mailing Address - Street 1:16921 PARTHENIA ST.
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91343-4559
Mailing Address - Country:US
Mailing Address - Phone:818-893-8883
Mailing Address - Fax:818-893-9889
Practice Address - Street 1:16921 PARTHENIA ST.
Practice Address - Street 2:SUITE 303
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91343-4559
Practice Address - Country:US
Practice Address - Phone:818-893-8883
Practice Address - Fax:818-893-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-01
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
CA550007998251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550007998Medicaid
551761Medicare Oscar/Certification