Healthcare Provider Details

I. General information

NPI: 1194830513
Provider Name (Legal Business Name): ANGELS OF THE VALLEY HOSPICE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 HONOLULU AVE SUITE 115
MONTROSE CA
91020-1800
US

IV. Provider business mailing address

2490 HONOLULU AVE SUITE 115
MONTROSE CA
91020-1800
US

V. Phone/Fax

Practice location:
  • Phone: 818-542-3070
  • Fax: 818-542-3071
Mailing address:
  • Phone: 818-542-3070
  • Fax: 818-542-3071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number980001553
License Number StateCA

VIII. Authorized Official

Name: MS. ROWENA I ARGONZA
Title or Position: C.F.O.
Credential:
Phone: 818-542-3070