MEDICARE: LOVING SOUL 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	:	1790323566
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING SOUL HOSPICE

Provider Business Mailing Address
First Line	:	14545 FRIAR ST STE 221
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91411-4719
Country	:	US
Telephone Number	:	818-946-8182
Fax Number	:

Provider Business Practice Location Address
First Line	:	14545 FRIAR ST STE 221
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91411-4719
Country	:	US
Telephone Number	:	818-946-8182
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ALINA GENHOZYAN
Credential	:
Telephone Number	:	818-387-6024

Provider Enumeration Date	:	12/12/2019
Last Update Date	:	12/12/2019

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Directions to “LOVING SOUL HOSPICE ” Practice Location

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