Provider Demographics
NPI:1336588110
Name:KAYA HOSPICE, INC
Entity Type:Organization
Organization Name:KAYA HOSPICE, INC
Other - Org Name:VALLEY'S BEST HOSPICE - AV
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:B
Authorized Official - Last Name:MICHAELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:818-761-1205
Mailing Address - Street 1:43805 15TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4756
Mailing Address - Country:US
Mailing Address - Phone:818-353-0042
Mailing Address - Fax:
Practice Address - Street 1:43805 15TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4756
Practice Address - Country:US
Practice Address - Phone:818-353-0042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-14
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550002670251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based