Provider Demographics
NPI:1104594472
Name:AMAZING CARE HOSPICE, LLC.
Entity type:Organization
Organization Name:AMAZING CARE HOSPICE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/TREASURER/SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:CLEMENT
Authorized Official - Middle Name:
Authorized Official - Last Name:ATABOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-306-8830
Mailing Address - Street 1:101 PARKSHORE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-4726
Mailing Address - Country:US
Mailing Address - Phone:916-306-8830
Mailing Address - Fax:916-306-5570
Practice Address - Street 1:101 PARKSHORE DR STE 100
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4726
Practice Address - Country:US
Practice Address - Phone:916-306-8830
Practice Address - Fax:916-306-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based