Provider Demographics
NPI:1265052534
Name:VISITING ANGELS OF LA HOSPICE INC.
Entity type:Organization
Organization Name:VISITING ANGELS OF LA HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:AQUINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-477-3552
Mailing Address - Street 1:13615 VICTORY BLVD STE 224
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6406
Mailing Address - Country:US
Mailing Address - Phone:818-477-3552
Mailing Address - Fax:818-488-2231
Practice Address - Street 1:13615 VICTORY BLVD STE 224
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-6406
Practice Address - Country:US
Practice Address - Phone:818-477-3552
Practice Address - Fax:818-488-2231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based