Provider Demographics
NPI:1902575004
Name:GREAT VALUE HOSPICE CARE
Entity Type:Organization
Organization Name:GREAT VALUE HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALLAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-723-1406
Mailing Address - Street 1:10568 MAGNOLIA AVE STE 124
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-5864
Mailing Address - Country:US
Mailing Address - Phone:888-350-3113
Mailing Address - Fax:
Practice Address - Street 1:10568 MAGNOLIA AVE STE 124
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-5864
Practice Address - Country:US
Practice Address - Phone:888-350-3113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based