Provider Demographics
NPI:1821672692
Name:DIVINE HEARTS HOSPICE INC
Entity Type:Organization
Organization Name:DIVINE HEARTS HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDIZNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-208-0924
Mailing Address - Street 1:260 MAPLE CT STE 117
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3547
Mailing Address - Country:US
Mailing Address - Phone:949-208-0924
Mailing Address - Fax:
Practice Address - Street 1:260 MAPLE CT STE 117
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3547
Practice Address - Country:US
Practice Address - Phone:949-208-0924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based