CANYON LAKE HOSPICE INC. NPI 1205260130

NPI Information

CANYON LAKE HOSPICE, INC. is a hospice care community based in Temecula, CA. CANYON LAKE HOSPICE, INC. NPI is 1205260130. The provider is registered as an organization entity type.
The provider Is Doing Business As Good Heart Hospice@palliative Care.

The provider's business location address is:

41661 ENTERPRISE CIR N STE 217
TEMECULA, CA
ZIP 92590
Phone: (951) 296-0082
Fax: (951) 296-0083

The provider's authorized official is Maya Mellina Thona .
The authorized official title is Authorized Official/dpcs and has the following contact phone number (714) 606-7986.

The CLIA number assigned to this NPI record is 05D2158725 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/28/2013 and was last updated on 4/13/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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