New Haven Hospice Care, Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

080000792 Issued in CA

Legal business name

NEW HAVEN HOSPICE CARE, INC

Practice address

1700 E. Lincoln Ave #202
Anaheim, CA 92805-4323

Phone

(714) 774-2498

Fax

(714) 774-2485

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Procopio T. Misa

Title

Authorized Official

Phone

(714) 774-2498

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550448000000",
    "number": "1770539256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E. LINCOLN AVE #202",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054323",
            "telephone_number": "714-774-2498",
            "fax_number": "714-774-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E. LINCOLN AVE #202",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054323",
            "telephone_number": "714-774-2498",
            "fax_number": "714-774-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HAVEN HOSPICE CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2019-02-18",
        "status": "A",
        "authorized_official_last_name": "MISA",
        "authorized_official_first_name": "PROCOPIO",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "714-774-2498"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": "080000792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA SECRETARY OF STATE",
            "identifier": "C2557938",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HPC01788F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.