Provider Demographics
NPI:1689181323
Name:OPTIMAL HOSPICE, INC.
Entity Type:Organization
Organization Name:OPTIMAL HOSPICE, INC.
Other - Org Name:BRISTOL HOSPICE - LANCASTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:E
Authorized Official - Last Name:MAURICIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-656-2769
Mailing Address - Street 1:1227 CHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-5445
Mailing Address - Country:US
Mailing Address - Phone:661-410-3000
Mailing Address - Fax:
Practice Address - Street 1:44151 15TH ST W STE 201
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4079
Practice Address - Country:US
Practice Address - Phone:661-674-3300
Practice Address - Fax:661-206-4417
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMAL HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-03
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550004054251G00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based