Healthcare Provider Details

I. General information

NPI: 1689420101
Provider Name (Legal Business Name): HEAVENLY PEACE HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2024
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13609 VICTORY BLVD STE 235
VAN NUYS CA
91401-6437
US

IV. Provider business mailing address

13609 VICTORY BLVD STE 235
VAN NUYS CA
91401-6437
US

V. Phone/Fax

Practice location:
  • Phone: 818-900-9202
  • Fax:
Mailing address:
  • Phone: 818-900-9202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALEKSAN ALIK KARAPETYAN
Title or Position: CEO
Credential:
Phone: 818-900-9202