Provider Demographics
NPI:1710569355
Name:DEPENDABLE NURSING HOSPICE LLC
Entity Type:Organization
Organization Name:DEPENDABLE NURSING HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACKSON
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-602-0583
Mailing Address - Street 1:5055 AVENIDA ENCINAS STE 120B
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-4375
Mailing Address - Country:US
Mailing Address - Phone:760-602-0583
Mailing Address - Fax:
Practice Address - Street 1:5055 AVENIDA ENCINAS STE 120B
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-4375
Practice Address - Country:US
Practice Address - Phone:760-602-0583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based