Provider Demographics
NPI:1871574251
Name:ASSURANCE HOSPICE, INC.
Entity type:Organization
Organization Name:ASSURANCE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:SY GO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-793-3374
Mailing Address - Street 1:444 E HUNTINGTON DR STE 103
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-6257
Mailing Address - Country:US
Mailing Address - Phone:626-793-3374
Mailing Address - Fax:626-793-3324
Practice Address - Street 1:444 E HUNTINGTON DR STE 103
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-6257
Practice Address - Country:US
Practice Address - Phone:626-793-3374
Practice Address - Fax:626-793-3324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001596251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01784FMedicaid
05-1784Medicare ID - Type Unspecified