Provider Demographics
NPI:1669739876
Name:EXCELLENCE HOSPICE CARE.,INC.
Entity type:Organization
Organization Name:EXCELLENCE HOSPICE CARE.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:IRVING
Authorized Official - Middle Name:
Authorized Official - Last Name:ABAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-818-9064
Mailing Address - Street 1:21133 VICTORY BLVD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-2829
Mailing Address - Country:US
Mailing Address - Phone:818-431-8112
Mailing Address - Fax:
Practice Address - Street 1:21133 VICTORY BLVD
Practice Address - Street 2:SUITE 215
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303
Practice Address - Country:US
Practice Address - Phone:818-468-5513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA751547Medicare Oscar/Certification