Provider Demographics
NPI:1538168950
Name:THE ELIZABETH HOSPICE, INC.
Entity type:Organization
Organization Name:THE ELIZABETH HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCSPADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:760-737-2050
Mailing Address - Street 1:500 LA TERRAZA BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3875
Mailing Address - Country:US
Mailing Address - Phone:760-737-2050
Mailing Address - Fax:760-796-3785
Practice Address - Street 1:500 LA TERRAZA BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3875
Practice Address - Country:US
Practice Address - Phone:760-737-2050
Practice Address - Fax:760-796-3785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA080000519207QH0002X, 207RH0002X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC 01528FMedicaid
051528Medicare UPIN