Provider Demographics
NPI:1922541887
Name:JOSHUA TREE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:JOSHUA TREE HEALTHCARE, INC.
Other - Org Name:BUENA VISTA PALLIATIVE CARE & HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOCHNOUR
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:208-401-1365
Mailing Address - Street 1:1732 PALMA DR
Mailing Address - Street 2:#108
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5796
Mailing Address - Country:US
Mailing Address - Phone:805-676-1453
Mailing Address - Fax:
Practice Address - Street 1:1732 PALMA DR
Practice Address - Street 2:#108
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5796
Practice Address - Country:US
Practice Address - Phone:805-676-1453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty