MEDICARE: ANGEL CARE HOSPICE LLC.

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	:	1346882610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL CARE HOSPICE LLC.

Provider Business Mailing Address
First Line	:	4100 W ALAMEDA AVE STE 385
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4195
Country	:	US
Telephone Number	:	747-200-5470
Fax Number	:	747-200-1927

Provider Business Practice Location Address
First Line	:	4100 W ALAMEDA AVE STE 385
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4195
Country	:	US
Telephone Number	:	747-200-5470
Fax Number	:	747-200-1927

Authorized Official
Title or Position	:	CEO
Name	:	JENNIFER VALDES
Credential	:
Telephone Number	:	747-200-5470

Provider Enumeration Date	:	10/08/2019
Last Update Date	:	12/07/2022

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