Provider Demographics
NPI:1487097374
Name:COMMUNITY CARE AND HOSPICE LLC
Entity type:Organization
Organization Name:COMMUNITY CARE AND HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, DPCS, DON
Authorized Official - Prefix:
Authorized Official - First Name:USHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOKATAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MSN, DPCS
Authorized Official - Phone:805-667-8558
Mailing Address - Street 1:4000 CALLE TECATE STE 114
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5285
Mailing Address - Country:US
Mailing Address - Phone:805-667-8558
Mailing Address - Fax:805-384-0933
Practice Address - Street 1:4000 CALLE TECATE STE 114
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-5285
Practice Address - Country:US
Practice Address - Phone:805-667-8558
Practice Address - Fax:805-384-0933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA461458002251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based