Provider Demographics
NPI:1386128353
Name:ANGELICA HOSPICE AND PALLIATIVE CARE LLC
Entity type:Organization
Organization Name:ANGELICA HOSPICE AND PALLIATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:WAIRIMU
Authorized Official - Last Name:KABATA
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:909-379-3446
Mailing Address - Street 1:1660 S ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 217
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3073
Mailing Address - Country:US
Mailing Address - Phone:602-903-7154
Mailing Address - Fax:602-892-9676
Practice Address - Street 1:1660 S ALMA SCHOOL RD
Practice Address - Street 2:SUITE 217
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3073
Practice Address - Country:US
Practice Address - Phone:602-903-7154
Practice Address - Fax:602-892-9676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based