MEDICARE: NOHO 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1184061616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOHO HOSPICE, INC.

Provider Business Mailing Address
First Line	:	717 S. VICTORY BLVD SUITE B
Second Line	:	UNIT C
City	:	BURBANK
State	:	CA
Zip	:	91502-7171
Country	:	US
Telephone Number	:	888-594-9188
Fax Number	:

Provider Business Practice Location Address
First Line	:	4942 VINELAND AVE
Second Line	:	UNIT C
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-5637
Country	:	US
Telephone Number	:	818-821-3431
Fax Number	:	818-821-3441

Authorized Official
Title or Position	:	CEO
Name	:	MARGARET GAVGAVYAN
Credential	:
Telephone Number	:	888-594-9188

Provider Enumeration Date	:	05/23/2013
Last Update Date	:	03/04/2015

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