Provider Demographics
NPI:1356910467
Name:RENAISSANCE HOSPICE INC
Entity type:Organization
Organization Name:RENAISSANCE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NITIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-682-1422
Mailing Address - Street 1:860 E LA HABRA BLVD STE 210A
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-0817
Mailing Address - Country:US
Mailing Address - Phone:909-682-1422
Mailing Address - Fax:
Practice Address - Street 1:860 E LA HABRA BLVD STE 210A
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-0817
Practice Address - Country:US
Practice Address - Phone:909-682-1422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based