Provider Demographics
NPI:1972747046
Name:COMPCARE HOSPICE, INC.
Entity Type:Organization
Organization Name:COMPCARE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MONTEGRANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-782-0441
Mailing Address - Street 1:3550 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 1022
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010
Mailing Address - Country:US
Mailing Address - Phone:323-782-0441
Mailing Address - Fax:323-782-1810
Practice Address - Street 1:3550 WILSHIRE BLVD
Practice Address - Street 2:SUITE 1022
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010
Practice Address - Country:US
Practice Address - Phone:323-782-0441
Practice Address - Fax:323-782-1810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551638Medicare Oscar/Certification