Provider Demographics
NPI:1740741529
Name:COMPASSIONATE CARE HOSPICE CENTRAL CALIFORNIA LLC
Entity Type:Organization
Organization Name:COMPASSIONATE CARE HOSPICE CENTRAL CALIFORNIA LLC
Other - Org Name:COMPASSIONATE CARE HOSPICE CENTRAL CALIFORNIA LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRISTIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:KASDORF VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-432-2003
Mailing Address - Street 1:7545 N DEL MAR AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-5847
Mailing Address - Country:US
Mailing Address - Phone:559-432-2003
Mailing Address - Fax:559-899-0967
Practice Address - Street 1:7545 N DEL MAR AVE STE 204
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-5847
Practice Address - Country:US
Practice Address - Phone:559-432-2003
Practice Address - Fax:559-705-1910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-26
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based