Provider Demographics
NPI:1821224452
Name:VICAR HOSPICE, INC.
Entity Type:Organization
Organization Name:VICAR HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VILMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-389-2130
Mailing Address - Street 1:27303 EAST BASE LINE AVE.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-3258
Mailing Address - Country:US
Mailing Address - Phone:909-520-0782
Mailing Address - Fax:
Practice Address - Street 1:27303 EAST BASE LINE AVE.
Practice Address - Street 2:SUITE 201
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-3258
Practice Address - Country:US
Practice Address - Phone:909-520-0782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000490251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based