Blue Water Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BLUE WATER HOSPICE INC

Practice address

12361 Lewis St Ste 201
Garden Grove, CA 92840-4617

Phone

(657) 465-5381

Fax

(657) 465-5382

NPI assigned

Feb 4, 2015

Organization subpart

No

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

Authorized official

Name

Benjamin Cabrera

Title

Owner

Phone

(310) 220-1499

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1821488339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12361 LEWIS ST STE 201",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404617",
            "telephone_number": "657-465-5381",
            "fax_number": "657-465-5382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12361 LEWIS ST STE 201",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404617",
            "telephone_number": "657-465-5381",
            "fax_number": "657-465-5382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-04",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "CABRERA",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-220-1499"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Garden Grove, CA
• Providers in Garden Grove, 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 Apr 26, 2023; 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.