Provider Demographics
NPI:1053999631
Name:RED DAWN HOSPICE INC
Entity type:Organization
Organization Name:RED DAWN HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SALLAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-239-6608
Mailing Address - Street 1:333 S JUNIPER ST STE 214
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4924
Mailing Address - Country:US
Mailing Address - Phone:760-239-6608
Mailing Address - Fax:760-683-3040
Practice Address - Street 1:333 S JUNIPER ST STE 214
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4924
Practice Address - Country:US
Practice Address - Phone:760-239-6608
Practice Address - Fax:760-683-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based