Organization Name: | ANGEL CITY HOSPICE, INC. |
NPI Number: | 1588998298 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JONE JADE ACAPULCO BAUTISTA (CEO) |
Mailing Address: | 5000 W Oakey Blvd Suite A6 Las Vegas |
State: | NV US |
Postal Code: | 891463393 |
Phone Number: | 7028585808 |
Fax Number: | |
NPI Enumeration Date: | 09/28/2009 |
NPI Last Update Date: | 09/28/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 5185HPC-0 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |