MEDICARE: REST AT HOME 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	:	1982203949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REST AT HOME HOSPICE INC

Provider Business Mailing Address
First Line	:	11336 CAMARILLO ST STE 307
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-3501
Country	:	US
Telephone Number	:	818-570-7109
Fax Number	:

Provider Business Practice Location Address
First Line	:	11336 CAMARILLO ST STE 307
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-3501
Country	:	US
Telephone Number	:	818-570-7109
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KARINE AVAGIAN
Credential	:
Telephone Number	:	818-570-7109

Provider Enumeration Date	:	10/21/2020
Last Update Date	:	10/21/2020

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Directions to “REST AT HOME HOSPICE INC ” Practice Location

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