Provider Demographics
NPI:1902206162
Name:HOLLYWOOD HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:HOLLYWOOD HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTACT PERSON
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-828-5658
Mailing Address - Street 1:13615 VICTORY BLVD
Mailing Address - Street 2:UNIT 120
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-1737
Mailing Address - Country:US
Mailing Address - Phone:818-779-7706
Mailing Address - Fax:818-779-7714
Practice Address - Street 1:13615 VICTORY BLVD
Practice Address - Street 2:UNIT 120
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1737
Practice Address - Country:US
Practice Address - Phone:818-779-7706
Practice Address - Fax:818-779-7714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based