MEDICARE: LENTA HOSPICE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH1000X	Hospice Registered Nurse

General Provider Information

NPI Number	:	1053931444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LENTA HOSPICE INC

Provider Business Mailing Address
First Line	:	3330 BARHAM BLVD # 3201
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-1400
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 BARHAM BLVD # 3201
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-1400
Country	:	US
Telephone Number	:	323-578-0830
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ASHOT AVAGIAN
Credential	:
Telephone Number	:	323-578-0830

Provider Enumeration Date	:	04/25/2020
Last Update Date	:	02/22/2023

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