MEDICARE: HOPELIGHT HOSPICE, 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	:	1366110983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPELIGHT HOSPICE, INC.

Provider Business Mailing Address
First Line	:	117 S LOUISE ST STE 307
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1076
Country	:	US
Telephone Number	:	818-391-1188
Fax Number	:	818-391-1189

Provider Business Practice Location Address
First Line	:	117 S LOUISE ST STE 307
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1076
Country	:	US
Telephone Number	:	818-391-1188
Fax Number	:	818-391-1189

Authorized Official
Title or Position	:	CEO
Name	:	MRS. AYLA THOMASSIAN
Credential	:
Telephone Number	:	818-391-1188

Provider Enumeration Date	:	08/30/2021
Last Update Date	:	08/30/2021

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