Provider Demographics
NPI:1962024760
Name:SHORES HOSPICE LLC
Entity Type:Organization
Organization Name:SHORES HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-951-5454
Mailing Address - Street 1:2424 VISTA WAY STE 206
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6178
Mailing Address - Country:US
Mailing Address - Phone:858-951-5454
Mailing Address - Fax:
Practice Address - Street 1:2424 VISTA WAY STE 206
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6178
Practice Address - Country:US
Practice Address - Phone:858-951-5454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based