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NPI 1184397952

NPI 1184397952 : ANGEL WINGS HOSPICE INC : NORTH HOLLYWOOD, CA

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General NPI Number Information
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    NPI Number           |    1184397952
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    Entity Type          |    Organization 
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    Legal Business Name  |    ANGEL WINGS HOSPICE INC 
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Dates
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    Enumeration Date     |    07/28/2021
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    Last Update Date     |    07/28/2021
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Provider Practice Location Address
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    Address Line         |    5958 VINELAND AVE STE G 
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    City                 |    NORTH HOLLYWOOD
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    State                |    CA
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    Zip                  |    91601-1329
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    Country              |    US
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    Telephone            |    323-268-3101
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    Fax                  |    323-986-6199
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Provider Business Mailing Address
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    Address Line         |    5958 VINELAND AVE STE G 
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    City                 |    NORTH HOLLYWOOD
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    State                |    CA
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    Zip                  |    91601-1329
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    Country              |    US
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    Telephone            |    323-268-3101
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    Fax                  |    323-986-6199
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     ANNA  BOYRAZYAN 
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    Credential           |    
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    Telephone            |    323-268-3101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251G00000X
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    Taxonomy Name        |    Community Based Hospice Care Agency
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    License Number       |    
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    License Number State |    
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