Provider Demographics
NPI:1427497981
Name:WHITE WINGS HOSPICE INC
Entity type:Organization
Organization Name:WHITE WINGS HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BELLE
Authorized Official - Middle Name:CAGAYAN
Authorized Official - Last Name:NISHIMURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-342-6921
Mailing Address - Street 1:PO BOX 3004
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-9004
Mailing Address - Country:US
Mailing Address - Phone:626-342-6921
Mailing Address - Fax:818-450-1455
Practice Address - Street 1:1050 LAKES DR STE 225
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2910
Practice Address - Country:US
Practice Address - Phone:714-390-6681
Practice Address - Fax:818-450-1455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based