MEDICARE: ROZE ROOM HOSPICE OF THE VALLEY 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	980001512	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669474987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROZE ROOM HOSPICE OF THE VALLEY INC

Provider Business Mailing Address
First Line	:	18107 SHERMAN WAY
Second Line	:	SUITE 200
City	:	RESEDA
State	:	CA
Zip	:	91335-4582
Country	:	US
Telephone Number	:	818-783-1002
Fax Number	:	818-783-1066

Provider Business Practice Location Address
First Line	:	18107 SHERMAN WAY
Second Line	:	SUITE 200
City	:	RESEDA
State	:	CA
Zip	:	91335-4582
Country	:	US
Telephone Number	:	818-783-1002
Fax Number	:	818-783-1066

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LENA MICHELLE BEKER
Credential	:
Telephone Number	:	818-783-1002

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	11/19/2016

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