Peaceful Haven Palliative Care, Incorporated.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PEACEFUL HAVEN PALLIATIVE CARE, INCORPORATED.

Practice address

450 N Brand Blvd Ste 600673
Glendale, CA 91203-2347

Phone

(818) 505-4836

NPI assigned

Jan 5, 2021

Organization subpart

No

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

Authorized official

Name

Carmen Cordero

Title

Consultant

Phone

(323) 828-5658

Specialties & licenses 1

Addresses

Other names 1

• No Other name

Locations

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619913600000",
    "number": "1457949547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5957 PRESTWICK WAY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365136",
            "telephone_number": "323-828-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N BRAND BLVD STE 600673",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032347",
            "telephone_number": "818-505-4836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL HAVEN PALLIATIVE CARE, INCORPORATED.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A",
        "authorized_official_last_name": "CORDERO",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "323-828-5658"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "No",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "No",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Community Based Hospice Care Agency in Glendale, CA
• Providers in Glendale, 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 May 2, 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.