Healthcare Provider Details

I. General information

NPI: 1982961504
Provider Name (Legal Business Name): AMENITY HOSPICE CARE OF LOS ANGELES,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 04/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3407 W 6TH ST SUITE 505
LOS ANGELES CA
90020-2537
US

IV. Provider business mailing address

3407 W 6TH ST SUITE 505
LOS ANGELES CA
90020-2537
US

V. Phone/Fax

Practice location:
  • Phone: 231-387-4200
  • Fax: 213-387-4205
Mailing address:
  • Phone: 231-387-4200
  • Fax: 213-387-4205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LOUISA TAKOUHI SEPEDJIAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 213-387-4200