Provider Demographics
NPI:1194142174
Name:HINDS HOSPICE
Entity type:Organization
Organization Name:HINDS HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:G
Authorized Official - Last Name:KLIMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-266-5683
Mailing Address - Street 1:2490 W SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3305
Mailing Address - Country:US
Mailing Address - Phone:559-317-6023
Mailing Address - Fax:559-248-8580
Practice Address - Street 1:2490 W SHAW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3305
Practice Address - Country:US
Practice Address - Phone:559-317-6023
Practice Address - Fax:559-248-8580
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HINDS HOSPICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-27
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100000749261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA051571Medicare Oscar/Certification