Healthcare Provider Details

I. General information

NPI: 1649884834
Provider Name (Legal Business Name): ENSURE HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 09/03/2020
Certification Date: 09/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609B E PALMDALE BLVD
PALMDALE CA
93550-4881
US

IV. Provider business mailing address

1609B E PALMDALE BLVD
PALMDALE CA
93550-4881
US

V. Phone/Fax

Practice location:
  • Phone: 747-262-5572
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: YANA ROSTOMYAN
Title or Position: OWNER
Credential:
Phone: 747-262-5572