Provider Demographics
NPI:1841866829
Name:HEELAS HOSPICE INC
Entity type:Organization
Organization Name:HEELAS HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/INCORPORATOR
Authorized Official - Prefix:
Authorized Official - First Name:UCHECHI
Authorized Official - Middle Name:
Authorized Official - Last Name:ESOMONU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:510-684-4042
Mailing Address - Street 1:2777 ALVARADO ST STE A
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-5701
Mailing Address - Country:US
Mailing Address - Phone:510-684-4042
Mailing Address - Fax:510-244-2401
Practice Address - Street 1:2777 ALVARADO ST STE A
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-5701
Practice Address - Country:US
Practice Address - Phone:510-684-4042
Practice Address - Fax:510-244-2401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based