Provider Demographics
NPI:1780358333
Name:DAHLIA HOSPICE
Entity type:Organization
Organization Name:DAHLIA HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:SHAHRAM
Authorized Official - Last Name:MARLEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-772-0753
Mailing Address - Street 1:7881 W CHARLESTON BLVD STE 190
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8325
Mailing Address - Country:US
Mailing Address - Phone:725-218-3561
Mailing Address - Fax:
Practice Address - Street 1:7881 W CHARLESTON BLVD STE 190
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8325
Practice Address - Country:US
Practice Address - Phone:725-218-3561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based