Antelope Valley Supportive Care and Hospice Non-Profit

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ANTELOPE VALLEY SUPPORTIVE CARE AND HOSPICE NON-PROFIT

Practice address

1505 W Avenue J Ste 303
Lancaster, CA 93534-2845

Phone

(661) 247-8345

NPI assigned

Jan 29, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Khodabakhsh, MD

Title

Ceo / Medical Director

Phone

(661) 247-8345

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1114730553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 W AVENUE J STE 303",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342845",
            "telephone_number": "661-247-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W AVENUE J STE 303",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342845",
            "telephone_number": "661-247-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTELOPE VALLEY SUPPORTIVE CARE AND HOSPICE NON-PROFIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "KHODABAKHSH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO / MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "661-247-8345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antelope Valley Primary Care Group
• Antelope Valley Rehabilitation Centers
• Antelope Valley Ride Inc.
• Antelope Valley SNF Healthcare, LLC
• Antelope Valley Supportive Care & Hosp
• Antelope Valley Surgery Center LP
• Antelope Valley Surgical Associates
• Antelope Valley Surgical Institute, LLC
• Antelope Valley Transit Authority
• Antelope Valley Union High School District

• Community Based Hospice Care Agency in Lancaster, CA
• Providers in Lancaster, 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 Jan 29, 2025; 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.