Provider Demographics
NPI:1841410164
Name:SILVERADO HOSPICE, INC.
Entity Type:Organization
Organization Name:SILVERADO HOSPICE, INC.
Other - Org Name:SILVERADO HOSPICE LOS ANGELES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEETSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-240-7200
Mailing Address - Street 1:6400 OAK CANYON
Mailing Address - Street 2:200
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-5233
Mailing Address - Country:US
Mailing Address - Phone:949-240-7200
Mailing Address - Fax:949-930-4014
Practice Address - Street 1:15821 VENTURA BLVD STE 515
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-848-4048
Practice Address - Fax:818-848-8464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000578251G00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551534Medicare Oscar/Certification