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General NPI Number Information
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NPI Number | 1780081554
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Entity Type | Organization
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Legal Business Name | HEAVENLY GATES HOSPICE, INC.
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Dates
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Enumeration Date | 11/22/2014
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Last Update Date | 11/22/2014
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Provider Practice Location Address
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Address Line | 1720 E LOS ANGELES AVE SUITE 230-232
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City | SIMI VALLEY
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State | CA
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Zip | 93065-2033
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Country | US
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Telephone | 805-522-5512
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Fax | 805-522-5517
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Provider Business Mailing Address
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Address Line | 1720 E LOS ANGELES AVE SUITE 230-232
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City | SIMI VALLEY
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State | CA
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Zip | 93065-2033
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Country | US
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Telephone | 805-522-5512
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Fax | 805-522-5517
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Authorized Official
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Title or Position | CEO
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Name | MRS. ARMINE CHALABIAN
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Credential |
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Telephone | 805-522-5512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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