MEDICARE: HOLLY TRINITY 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	:	1851837413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLLY TRINITY HOSPICE, INC.

Provider Business Mailing Address
First Line	:	6340 COLDWATER CANYON AVE STE 203
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-2908
Country	:	US
Telephone Number	:	818-502-0724
Fax Number	:	818-502-0729

Provider Business Practice Location Address
First Line	:	6340 COLDWATER CANYON AVE STE 203
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-2908
Country	:	US
Telephone Number	:	818-502-0724
Fax Number	:	818-502-0729

Authorized Official
Title or Position	:	CEO
Name	:	OREN SHACHAR
Credential	:
Telephone Number	:	818-502-0724

Provider Enumeration Date	:	01/06/2017
Last Update Date	:	07/22/2025

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