=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750804712
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VALLEY REGIONAL HOSPICE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/21/2017
-----------------------------------------------------
Last Update Date | 01/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6311 N FRESNO ST STE 103
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-431-3333
-----------------------------------------------------
Fax | 559-431-9777
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6311 N FRESNO ST STE 103
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93710-5290
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-431-3333
-----------------------------------------------------
Fax | 559-431-9777
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR/OWNER
-----------------------------------------------------
Name | MRS. MARI ZAKARYAN
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 559-431-3333
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 315D00000X
-----------------------------------------------------
Taxonomy Name | Inpatient Hospice
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------