Provider Demographics
NPI:1316168016
Name:CARECHOICES HOSPICE AND PALLIATIVE SERVICES, LLC
Entity type:Organization
Organization Name:CARECHOICES HOSPICE AND PALLIATIVE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HEXIMER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:949-777-8600
Mailing Address - Street 1:20 CORPORATE PARK STE 300
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-5189
Mailing Address - Country:US
Mailing Address - Phone:949-777-8600
Mailing Address - Fax:949-777-8629
Practice Address - Street 1:20 CORPORATE PARK STE 300
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-5189
Practice Address - Country:US
Practice Address - Phone:949-777-8600
Practice Address - Fax:949-777-8629
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARECHOICES NETWORK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-01
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000207251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
551529Medicare UPIN