MEDICARE: CHERUB INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1265076277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHERUB INC

Provider Business Mailing Address
First Line	:	9608 VAN NUYS BLVD STE 202
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91402-1043
Country	:	US
Telephone Number	:	818-446-6696
Fax Number	:	818-337-7220

Provider Business Practice Location Address
First Line	:	9608 VAN NUYS BLVD STE 202
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91402-1043
Country	:	US
Telephone Number	:	818-446-6696
Fax Number	:	818-337-7220

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	RONALD T VANO
Credential	:
Telephone Number	:	661-644-8626

Provider Enumeration Date	:	11/01/2019
Last Update Date	:	08/11/2024

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Directions to “CHERUB INC ” Practice Location

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