Provider Demographics
NPI:1386911576
Name:PROCARE HOSPICE SERVICES, INC.
Entity type:Organization
Organization Name:PROCARE HOSPICE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:STA.MARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-885-6104
Mailing Address - Street 1:20832 ROSCOE BLVD
Mailing Address - Street 2:STE 214
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91306-2057
Mailing Address - Country:US
Mailing Address - Phone:818-885-6104
Mailing Address - Fax:818-885-2659
Practice Address - Street 1:20832 ROSCOE BLVD
Practice Address - Street 2:STE 214
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91306-2057
Practice Address - Country:US
Practice Address - Phone:818-885-6104
Practice Address - Fax:818-885-2659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based