Blue Skies Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

550002888 Issued in CA

Legal business name

BLUE SKIES HOSPICE, LLC

Practice address

570 N Towne Ave
Pomona, CA 91767-4826

Phone

(626) 338-7182

Fax

(626) 338-7609

NPI assigned

Aug 27, 2013

Last updated

Jul 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Romeo N Manalo Sr., MBA

Title

Owner/Ceo

Phone

(626) 338-7182

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1285068221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 N TOWNE AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917674826",
            "telephone_number": "626-338-7182",
            "fax_number": "626-338-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 N TOWNE AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917674826",
            "telephone_number": "626-338-7182",
            "fax_number": "626-338-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKIES HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-27",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "MANALO",
        "authorized_official_first_name": "ROMEO",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "626-338-7182",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": "550002888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tobias Konrad Boehm, D.D.S, PH.D.
• Alicia Sue Boggio, L.C.S.W.
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• Community Based Hospice Care Agency in Pomona, CA
• Providers in Pomona, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.