Blissful Support Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BLISSFUL SUPPORT HOSPICE, INC.

Practice address

4959 Palo Verde St # 202B-2
Montclair, CA 91763-2331

Phone

(951) 240-3470

Fax

(951) 381-9339

NPI assigned

Mar 24, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carlos Katigbak

Title

Ceo

Phone

(951) 240-3470

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1053998401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4959 PALO VERDE ST # 202B-2",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632331",
            "telephone_number": "951-240-3470",
            "fax_number": "951-381-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4959 PALO VERDE ST # 202B-2",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632331",
            "telephone_number": "951-240-3470",
            "fax_number": "951-381-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLISSFUL SUPPORT HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "KATIGBAK",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-240-3470"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.