Provider Demographics
NPI:1760822514
Name:ALLSTATE HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:ALLSTATE HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MON
Authorized Official - Middle Name:CHRISTIANI
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-979-3935
Mailing Address - Street 1:1447 E COLORADO ST STE D
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1595
Mailing Address - Country:US
Mailing Address - Phone:818-979-3935
Mailing Address - Fax:
Practice Address - Street 1:1447 E COLORADO ST STE D
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1595
Practice Address - Country:US
Practice Address - Phone:818-979-3935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies