=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245854835
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CALMEDIX HOSPICE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2020
-----------------------------------------------------
Last Update Date | 10/05/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9836 WHITE OAK AVE STE 207
-----------------------------------------------------
City | NORTHRIDGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91325-4848
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-208-0208
-----------------------------------------------------
Fax | 818-239-4451
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9836 WHITE OAK AVE STE 207
-----------------------------------------------------
City | NORTHRIDGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91325-4848
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-208-0208
-----------------------------------------------------
Fax | 818-239-4451
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MS. AMY KALAJIAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-208-0208
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------