Organization
PROFESSIONAL LIFECARE HOSPICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES CONRAD CONTRERAS NURSE PRATITIONER (CEO)
(818) 818-6509
Entity
Organization
Contact information
Practice address
8363 RESEDA BLVD UNIT 200B, NORTHRIDGE, CA 91324-4623
(818) 818-6509
(888) 315-8448
Mailing address
8363 RESEDA BLVD UNIT 200B, NORTHRIDGE, CA 91324-4623
(818) 818-6509
(888) 315-8448
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E3594539
DRIVERS LICENSE
CA
Enumeration date
07/24/2020
Last updated
07/24/2020
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