Healthcare Provider Details

I. General information

NPI: 1386571008
Provider Name (Legal Business Name): THE ANGELS OF HAVEN HOSPICE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13609 VICTORY BLVD STE 133
VAN NUYS CA
91401-6418
US

IV. Provider business mailing address

13609 VICTORY BLVD STE 133
VAN NUYS CA
91401-6418
US

V. Phone/Fax

Practice location:
  • Phone: 818-290-3157
  • Fax: 818-290-3163
Mailing address:
  • Phone: 818-290-3157
  • Fax: 818-290-3163

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: NOEL V VILLANUEVA
Title or Position: PRES / CEO
Credential:
Phone: 909-859-4307