Provider Demographics
NPI:1154562189
Name:ABUNDANT CARE HOSPICE, INC.
Entity type:Organization
Organization Name:ABUNDANT CARE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:HERNANDO
Authorized Official - Last Name:ARCILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-640-2128
Mailing Address - Street 1:40 N ALTADENA DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3386
Mailing Address - Country:US
Mailing Address - Phone:626-793-7705
Mailing Address - Fax:626-793-7705
Practice Address - Street 1:40 N ALTADENA DR
Practice Address - Street 2:SUITE 103
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3386
Practice Address - Country:US
Practice Address - Phone:626-793-7705
Practice Address - Fax:626-793-7705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-21
Last Update Date:2009-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based