Provider Demographics
NPI:1104457480
Name:VALHALLA HOSPICE LLC
Entity type:Organization
Organization Name:VALHALLA HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-583-7002
Mailing Address - Street 1:301 W BASTANCHURY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3427
Mailing Address - Country:US
Mailing Address - Phone:714-583-7002
Mailing Address - Fax:844-443-2629
Practice Address - Street 1:301 W BASTANCHURY RD STE 100
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3427
Practice Address - Country:US
Practice Address - Phone:714-583-7002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based