Archangel Light Hospice

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ARCHANGEL LIGHT HOSPICE

Practice address

2775 Tapo St Ste 202
Simi Valley, CA 93063-0467

Phone

(818) 388-7082

Fax

(818) 514-2068

NPI assigned

Jun 29, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Lesley Prince, MD

Title

President

Phone

(213) 344-9198

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1649840844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 TAPO ST STE 202",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930630467",
            "telephone_number": "818-388-7082",
            "fax_number": "818-514-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 TAPO ST STE 202",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930630467",
            "telephone_number": "818-388-7082",
            "fax_number": "818-514-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHANGEL LIGHT HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-344-9198",
        "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": []
}

• Heidi Ann Anticevich, PTA
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• Tyler James Arauza, B.A., R.B.T.
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• Delilah Zeina Arellanes, LMFT
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• Arizona Toxicology Management, LLC
• Saeed Arjomand Bigdeli

• Community Based Hospice Care Agency in Simi Valley, CA
• Providers in Simi Valley, 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 Jun 29, 2021; 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.