Provider Demographics
NPI:1720035066
Name:VIVA HOSPICE SERVICES INCORPORATED
Entity Type:Organization
Organization Name:VIVA HOSPICE SERVICES INCORPORATED
Other - Org Name:ABBEY HEALTH AND PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:562-461-0600
Mailing Address - Street 1:10230 ARTESIA BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6763
Mailing Address - Country:US
Mailing Address - Phone:562-461-0600
Mailing Address - Fax:562-461-0116
Practice Address - Street 1:10230 ARTESIA BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6763
Practice Address - Country:US
Practice Address - Phone:562-461-0600
Practice Address - Fax:562-461-0116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001479251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01781FMedicaid
CAHPC01781FMedicaid