MEDICARE: CARE HAVEN HOSPICE

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	:	1396314274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE HAVEN HOSPICE

Provider Business Mailing Address
First Line	:	8383 WILSHIRE BLVD
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2425
Country	:	US
Telephone Number	:	310-614-8540
Fax Number	:

Provider Business Practice Location Address
First Line	:	8383 WILSHIRE BLVD
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2425
Country	:	US
Telephone Number	:	310-614-8540
Fax Number	:

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	ANTONIO INGENTE
Credential	:	MD
Telephone Number	:	310-614-8540

Provider Enumeration Date	:	06/23/2021
Last Update Date	:	06/24/2021

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