Provider Demographics
NPI:1699382671
Name:LA ELDER HOSPICE AND PALLIATIVE CARE, INC.
Entity Type:Organization
Organization Name:LA ELDER HOSPICE AND PALLIATIVE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HIELDEEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:BONSALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-251-4006
Mailing Address - Street 1:6454 VAN NUYS BLVD STE 1108
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-1445
Mailing Address - Country:US
Mailing Address - Phone:747-251-4006
Mailing Address - Fax:
Practice Address - Street 1:6454 VAN NUYS BLVD STE 1108
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1445
Practice Address - Country:US
Practice Address - Phone:747-251-4006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based