Provider Demographics
NPI:1215769013
Name:PRESTIGE INFINITY HOSPICE
Entity type:Organization
Organization Name:PRESTIGE INFINITY HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERTRUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:OCHI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:386-478-8787
Mailing Address - Street 1:1209 SUNGLOW DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-2528
Mailing Address - Country:US
Mailing Address - Phone:352-598-5982
Mailing Address - Fax:352-570-9318
Practice Address - Street 1:1209 SUNGLOW DR
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-2528
Practice Address - Country:US
Practice Address - Phone:352-598-5982
Practice Address - Fax:352-570-9318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Single Specialty