| Organization Name: | HEAVENLY CARE HOSPICE CORP |
| NPI Number: | 1144243577 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FREDA JOY VASQUEZ PRIMICIAS (VICE PRESIDENT/TREASURER) |
| Mailing Address: | 4959 Palo Verde St Ste 106c Montclair |
| State: | CA US |
| Postal Code: | 917632331 |
| Phone Number: | 9096264242 |
| Fax Number: | 9096264545 |
| NPI Enumeration Date: | 07/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| 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: | |