Provider Demographics
NPI:1770253916
Name:FREEDOM HOSPICE OF SOUTHERN CALIFORNIA LLC
Entity Type:Organization
Organization Name:FREEDOM HOSPICE OF SOUTHERN CALIFORNIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARSHARAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-844-2855
Mailing Address - Street 1:2376 BOGUE RD
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-9213
Mailing Address - Country:US
Mailing Address - Phone:530-844-2855
Mailing Address - Fax:
Practice Address - Street 1:50 N LA CIENEGA BLVD STE 150
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3143
Practice Address - Country:US
Practice Address - Phone:530-844-2855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-19
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based