Provider Demographics
NPI:1740882612
Name:DEDICATION HOSPICE CARE INC.
Entity type:Organization
Organization Name:DEDICATION HOSPICE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:IRODA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSTAMOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-371-7171
Mailing Address - Street 1:516 PENNSFIELD PL STE 206
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5575
Mailing Address - Country:US
Mailing Address - Phone:805-371-7171
Mailing Address - Fax:805-371-9979
Practice Address - Street 1:516 PENNSFIELD PL STE 206
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5575
Practice Address - Country:US
Practice Address - Phone:805-371-7171
Practice Address - Fax:805-371-9979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-14
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based