Provider Demographics
NPI:1932779337
Name:CHRYSALIS HOSPICE AND PALLIATIVE CARE INC
Entity Type:Organization
Organization Name:CHRYSALIS HOSPICE AND PALLIATIVE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMERSON
Authorized Official - Middle Name:
Authorized Official - Last Name:HONTORIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-895-2548
Mailing Address - Street 1:1445 E LOS ANGELES AVE STE 301J
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2829
Mailing Address - Country:US
Mailing Address - Phone:773-895-2548
Mailing Address - Fax:
Practice Address - Street 1:1445 E LOS ANGELES AVE STE 301J
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2829
Practice Address - Country:US
Practice Address - Phone:773-895-2548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based