Provider Demographics
NPI:1821609660
Name:PD HOSPICE, INC.
Entity Type:Organization
Organization Name:PD HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-445-2032
Mailing Address - Street 1:8700 RESEDA BLVD STE 218
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4087
Mailing Address - Country:US
Mailing Address - Phone:747-202-0733
Mailing Address - Fax:818-350-1163
Practice Address - Street 1:8700 RESEDA BLVD STE 218
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4087
Practice Address - Country:US
Practice Address - Phone:747-202-0733
Practice Address - Fax:818-350-1163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based