| Organization Name: | KEYSTONE HOSPICE INCORPORATION |
| NPI Number: | 1336547611 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARMEN CORDERO (CONTACT PERSON) |
| Mailing Address: | 638 S Van Ness Ave Unit B Los Angeles |
| State: | CA US |
| Postal Code: | 900053201 |
| Phone Number: | 8186364110 |
| Fax Number: | |
| NPI Enumeration Date: | 12/18/2014 |
| NPI Last Update Date: | 12/18/2014 |
| 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: | |