Provider Demographics
NPI:1609227875
Name:IDEAL PALLIATIVE AND HOSPICE CARE, INC.
Entity type:Organization
Organization Name:IDEAL PALLIATIVE AND HOSPICE CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:HAYCELYN
Authorized Official - Middle Name:O
Authorized Official - Last Name:MADLANGBAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-310-0990
Mailing Address - Street 1:123 S. MISSION DRIVE
Mailing Address - Street 2:UNIT F
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1163
Mailing Address - Country:US
Mailing Address - Phone:626-310-0990
Mailing Address - Fax:626-310-0991
Practice Address - Street 1:123 S. MISSION DRIVE
Practice Address - Street 2:UNIT F
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1163
Practice Address - Country:US
Practice Address - Phone:626-310-0990
Practice Address - Fax:626-310-0991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based