Omegalife Hospice of California, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

OMEGALIFE HOSPICE OF CALIFORNIA, INC.

Practice address

21151 S Western Ave Ste 256
Torrance, CA 90501-1724

Phone

(310) 755-2540

NPI assigned

Nov 27, 2018

Organization subpart

No

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

Authorized official

Name

Shellydale P Gray

Title

Administrator

Phone

(310) 357-0398

Specialties & licenses 1

Addresses

Other names 1

• OmegaLife Hospice of California, Inc. Doing business as

Listed as

Omegalife Hospice of California, IncCCN A11595

Ownership

For-Profit

Certified

Aug 4, 2020

Medicare certification status

ActiveFrom the Provider of Services file

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1982174512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21151 S WESTERN AVE STE 256",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905011724",
            "telephone_number": "310-755-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21151 S WESTERN AVE STE 256",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905011724",
            "telephone_number": "310-755-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGALIFE HOSPICE OF CALIFORNIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-27",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "SHELLYDALE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-357-0398"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OmegaLife Hospice of California, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Based Hospice Care Agency in Torrance, CA
• Providers in Torrance, 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 Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.