MEDICARE: HOUSE OF ANGELS 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	:	1568861946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSE OF ANGELS HOSPICE INC.

Provider Business Mailing Address
First Line	:	5627 SEPULVEDA BLVD
Second Line	:	218
City	:	VAN NUYS
State	:	CA
Zip	:	91411-2920
Country	:	US
Telephone Number	:	818-538-5289
Fax Number	:	818-237-3038

Provider Business Practice Location Address
First Line	:	5627 SEPULVEDA BLVD
Second Line	:	218
City	:	VAN NUYS
State	:	CA
Zip	:	91411-2920
Country	:	US
Telephone Number	:	818-538-5289
Fax Number	:	818-237-3038

Authorized Official
Title or Position	:	CEO
Name	:	JUAN C. ESPARZA
Credential	:
Telephone Number	:	818-538-5289

Provider Enumeration Date	:	08/21/2014
Last Update Date	:	09/12/2022

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