Provider Demographics
NPI:1982201026
Name:BLESSED ANGEL HOSPICE INC.
Entity Type:Organization
Organization Name:BLESSED ANGEL HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FROYLAND
Authorized Official - Middle Name:BAMBA
Authorized Official - Last Name:TARUC
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-937-0877
Mailing Address - Street 1:11014 ELDORA AVE
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-2005
Mailing Address - Country:US
Mailing Address - Phone:818-335-2951
Mailing Address - Fax:
Practice Address - Street 1:11014 ELDORA AVE
Practice Address - Street 2:
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040-2005
Practice Address - Country:US
Practice Address - Phone:818-335-2951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based