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General NPI Number Information
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NPI Number | 1912321944
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Entity Type | Organization
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Legal Business Name | WHITE ROSE HOSPICE, INC.
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Dates
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Enumeration Date | 02/11/2014
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Last Update Date | 02/05/2021
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Provider Practice Location Address
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Address Line | 17337 VENTURA BLVD STE 107
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City | ENCINO
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State | CA
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Zip | 91316-3971
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Country | US
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Telephone | 818-330-5322
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Fax |
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Provider Business Mailing Address
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Address Line | 17337 VENTURA BLVD STE 107
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City | ENCINO
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State | CA
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Zip | 91316-3971
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Country | US
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Telephone | 818-330-5322
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | HAKEEM FAHM
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Credential |
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Telephone | 818-330-5322
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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 | CA
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