Heaven Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

HEAVEN HOSPICE, INC.

Practice address

14557 Friar St Ste B1
Van Nuys, CA 91411-2312

Phone

(818) 508-4210

Fax

(818) 508-4652

NPI assigned

Feb 11, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Roy Rubanenko

Title

Ceo

Phone

(818) 508-4210

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1104158419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14557 FRIAR ST STE B1",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112312",
            "telephone_number": "818-508-4210",
            "fax_number": "818-508-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14557 FRIAR ST STE B1",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112312",
            "telephone_number": "818-508-4210",
            "fax_number": "818-508-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVEN HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RUBANENKO",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-508-4210",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.