Provider Demographics
NPI:1982032710
Name:LVNV HOSPICE
Entity Type:Organization
Organization Name:LVNV HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTROMAYOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:714-408-6522
Mailing Address - Street 1:3301 SPRING MOUNTAIN RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-8648
Mailing Address - Country:US
Mailing Address - Phone:702-380-8202
Mailing Address - Fax:
Practice Address - Street 1:596 N LAKE AVE
Practice Address - Street 2:203
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1222
Practice Address - Country:US
Practice Address - Phone:626-272-5943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based