MEDICARE: SOLACE 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	:	1699342410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLACE HOSPICE INC

Provider Business Mailing Address
First Line	:	936 E GREEN ST STE 107
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-2946
Country	:	US
Telephone Number	:	818-730-2878
Fax Number	:

Provider Business Practice Location Address
First Line	:	936 E GREEN ST STE 107
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-2946
Country	:	US
Telephone Number	:	818-730-2878
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ROXAN SEVILLA
Credential	:	RN
Telephone Number	:	818-730-2878

Provider Enumeration Date	:	06/09/2021
Last Update Date	:	06/09/2021

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Directions to “SOLACE HOSPICE INC ” Practice Location

Language	Start Address	Practice Location

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