Provider Demographics
NPI:1982906947
Name:ACE HOSPICE CARE, INCORPORATION
Entity Type:Organization
Organization Name:ACE HOSPICE CARE, INCORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, DPCS
Authorized Official - Prefix:
Authorized Official - First Name:ANGELITA
Authorized Official - Middle Name:GABON
Authorized Official - Last Name:BALBUENA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:323-349-0597
Mailing Address - Street 1:4515 EAGLE ROCK BLVD
Mailing Address - Street 2:SUITE 151
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-3395
Mailing Address - Country:US
Mailing Address - Phone:323-349-0597
Mailing Address - Fax:323-349-0685
Practice Address - Street 1:4515 EAGLE ROCK BLVD
Practice Address - Street 2:SUITE 151
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-3395
Practice Address - Country:US
Practice Address - Phone:323-349-0685
Practice Address - Fax:323-349-0597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based