Provider Demographics
NPI:1841760378
Name:BLESSED PALLIATIVE AND HOSPICE SERVICE
Entity Type:Organization
Organization Name:BLESSED PALLIATIVE AND HOSPICE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIONISIO
Authorized Official - Middle Name:
Authorized Official - Last Name:PERALTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-416-1637
Mailing Address - Street 1:4132 KATELLA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3490
Mailing Address - Country:US
Mailing Address - Phone:562-588-3054
Mailing Address - Fax:562-794-9310
Practice Address - Street 1:4132 KATELLA AVE STE 101
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3490
Practice Address - Country:US
Practice Address - Phone:562-588-3054
Practice Address - Fax:562-794-9310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based