Provider Demographics
NPI:1689854010
Name:H & A HOSPICE INC.
Entity Type:Organization
Organization Name:H & A HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:SIM
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:805-583-3565
Mailing Address - Street 1:4288 E. LOS ANGELES AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063
Mailing Address - Country:US
Mailing Address - Phone:805-583-3565
Mailing Address - Fax:805-583-2208
Practice Address - Street 1:4288 E. LOS ANGELES AVE.
Practice Address - Street 2:SUITE 200
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063
Practice Address - Country:US
Practice Address - Phone:805-583-3565
Practice Address - Fax:805-583-2208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000514251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based