Provider Demographics
NPI:1518560390
Name:LAVENDER NIGHTS HOSPICE, INC.
Entity Type:Organization
Organization Name:LAVENDER NIGHTS HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-732-4406
Mailing Address - Street 1:6931 VAN NUYS BLVD STE 331L
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-3999
Mailing Address - Country:US
Mailing Address - Phone:818-732-4406
Mailing Address - Fax:818-732-4407
Practice Address - Street 1:6931 VAN NUYS BLVD STE 331L
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3999
Practice Address - Country:US
Practice Address - Phone:818-732-4406
Practice Address - Fax:818-732-4407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based