Provider Demographics
NPI:1366885154
Name:PASSIONATE HEART HOSPICE, INC.
Entity type:Organization
Organization Name:PASSIONATE HEART HOSPICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:VEDEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-794-1701
Mailing Address - Street 1:17100 PIONEER BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-2727
Mailing Address - Country:US
Mailing Address - Phone:818-541-9400
Mailing Address - Fax:818-541-9402
Practice Address - Street 1:17100 PIONEER BLVD STE 315
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-2727
Practice Address - Country:US
Practice Address - Phone:818-541-9400
Practice Address - Fax:818-541-9402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based