Provider Demographics
NPI:1194830513
Name:ANGELS OF THE VALLEY HOSPICE CARE, LLC
Entity Type:Organization
Organization Name:ANGELS OF THE VALLEY HOSPICE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.F.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:ROWENA
Authorized Official - Middle Name:I
Authorized Official - Last Name:ARGONZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-542-3070
Mailing Address - Street 1:2490 HONOLULU AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1800
Mailing Address - Country:US
Mailing Address - Phone:818-542-3070
Mailing Address - Fax:818-542-3071
Practice Address - Street 1:2490 HONOLULU AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1800
Practice Address - Country:US
Practice Address - Phone:818-542-3070
Practice Address - Fax:818-542-3071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001553251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01783FMedicaid
CA051783Medicare ID - Type UnspecifiedPROVIDER NO.