Organization Name: | BONITA SPRINGS HOSPICE CARE LLC |
NPI Number: | 1083014864 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SYEDA MAMOONA OMER (CEO/ADMINISTRATOR) |
Mailing Address: | 8545 Monterey St Unit B Gilroy |
State: | CA US |
Postal Code: | 950204273 |
Phone Number: | 4088481114 |
Fax Number: | 4088481115 |
NPI Enumeration Date: | 08/28/2014 |
NPI Last Update Date: | 12/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |