Provider Demographics
NPI:1922377878
Name:ALTA CARE HOSPICE INC
Entity type:Organization
Organization Name:ALTA CARE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:RAMOS
Authorized Official - Last Name:SORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-635-9639
Mailing Address - Street 1:7100 HAYVENHURST AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3844
Mailing Address - Country:US
Mailing Address - Phone:818-998-2582
Mailing Address - Fax:818-635-9639
Practice Address - Street 1:9029 RESEDA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-3932
Practice Address - Country:US
Practice Address - Phone:818-635-9639
Practice Address - Fax:818-635-9639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based