Provider Demographics
NPI:1710649587
Name:INNOVATIVE HOSPICE CARE INC
Entity Type:Organization
Organization Name:INNOVATIVE HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARVYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-526-5937
Mailing Address - Street 1:2102 BUSINESS CENTER DR STE 256
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1001
Mailing Address - Country:US
Mailing Address - Phone:949-535-1091
Mailing Address - Fax:
Practice Address - Street 1:2102 BUSINESS CENTER DR STE 256
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1001
Practice Address - Country:US
Practice Address - Phone:949-535-1091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based