Provider Demographics
NPI:1871180083
Name:CORVITA HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:CORVITA HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:
Authorized Official - Last Name:OSILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-221-5201
Mailing Address - Street 1:330 RANCHEROS DR STE 224
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2940
Mailing Address - Country:US
Mailing Address - Phone:951-221-5201
Mailing Address - Fax:760-890-6019
Practice Address - Street 1:330 RANCHEROS DR STE 224
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-2940
Practice Address - Country:US
Practice Address - Phone:951-221-5201
Practice Address - Fax:760-890-6019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based