GREAT LIFE HOSPICE NPI 1891104139

NPI Information

NPI: 1891104139
Provider Name: GREAT LIFE HOSPICE
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 05D2145202

Address:
14640 VICTORY BLVD STE 213
VAN NUYS, CA
ZIP 91411
Phone: (818) 779-1010
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GREAT LIFE HOSPICE is a hospice care community based in Van Nuys, CA. GREAT LIFE HOSPICE NPI is 1891104139. The provider is registered as an organization entity type.

The provider's business location address is:

14640 VICTORY BLVD STE 213
VAN NUYS, CA
ZIP 91411-197
Phone: (818) 779-1010

The provider's authorized official is Apollo Jolo Robles .
The authorized official title is Ceo and has the following contact phone number (818) 779-1010.

The CLIA number assigned to this NPI record is 05D2145202 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/12/2014 and was last updated on 1/31/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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