Provider Demographics
NPI:1023530359
Name:GOOD SAMARITAN HOSPICE OF ST. JOSEPH
Entity type:Organization
Organization Name:GOOD SAMARITAN HOSPICE OF ST. JOSEPH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-953-2161
Mailing Address - Street 1:2308 COTTON CT
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-7800
Mailing Address - Country:US
Mailing Address - Phone:707-953-2161
Mailing Address - Fax:
Practice Address - Street 1:2800 CLEVELAND AVE STE D
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2784
Practice Address - Country:US
Practice Address - Phone:707-953-2161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-07
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based