Provider Demographics
NPI:1780134981
Name:DIVINITY HOSPICE
Entity type:Organization
Organization Name:DIVINITY HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MSN, RN, FNP/ CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARBI
Authorized Official - Middle Name:
Authorized Official - Last Name:YAGHOUBI MASIHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-987-5373
Mailing Address - Street 1:2130 CHESTER AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-4472
Mailing Address - Country:US
Mailing Address - Phone:866-987-5373
Mailing Address - Fax:866-987-5374
Practice Address - Street 1:2130 CHESTER AVE STE 102
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4472
Practice Address - Country:US
Practice Address - Phone:866-987-5373
Practice Address - Fax:866-987-5374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based