Provider Demographics
NPI:1851973556
Name:MODERNE HOSPICE CARE INC
Entity Type:Organization
Organization Name:MODERNE HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/BOARD SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:G
Authorized Official - Last Name:VIGILIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:562-243-2061
Mailing Address - Street 1:3130 BONITA RD STE 108
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-3263
Mailing Address - Country:US
Mailing Address - Phone:619-500-5313
Mailing Address - Fax:619-500-5448
Practice Address - Street 1:3130 BONITA RD STE 108
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3263
Practice Address - Country:US
Practice Address - Phone:619-663-8912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based