Provider Demographics
NPI:1861818718
Name:FELLOWSHIP HOSPICE SERVICES INC.
Entity Type:Organization
Organization Name:FELLOWSHIP HOSPICE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JED
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:562-547-4677
Mailing Address - Street 1:520 N BROOKHURST ST STE 214
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5238
Mailing Address - Country:US
Mailing Address - Phone:562-462-0044
Mailing Address - Fax:562-462-0045
Practice Address - Street 1:520 N BROOKHURST ST STE 214
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5238
Practice Address - Country:US
Practice Address - Phone:562-462-0044
Practice Address - Fax:562-462-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based