ANTELOPE VALLEY SUPPORTIVE CARE AND HOSPICE NON-PROFIT
NPI 1114730553
Hospice Care, Community Based in Lancaster, CA

Active since January 29, 2025CLIA 05D2162644 · Waiver
1505 W AVENUE J STE 303, LANCASTER, CA 93534(661) 247-8345 Get Directions Write a Review

NPPES record last updated: January 29, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Antelope Valley Supportive Care And Hospice Non-profit NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANTELOPE VALLEY SUPPORTIVE CARE AND HOSPICE NON-PROFIT (NPI 1114730553) is a healthcare organization registered as a hospice care, community based in Lancaster, California and active in the NPI registry since January 2025. The organization holds a CLIA Waiver certificate valid through February 26, 2027 and lists Daniel Khodabakhsh, Ceo / Medical Director, as its authorized official.

NPPES Registry Identity

NPI1114730553
Entity TypeOrganization
Primary Taxonomy251G00000X
Legal Business NameANTELOPE VALLEY SUPPORTIVE CARE AND HOSPICE NON-PROFIT
Location Address1505 W AVENUE J STE 303Lancaster, CA 93534-2845
Mailing Address1505 W Avenue J Ste 303Lancaster, CA 93534-2845 · (661) 247-8345
Organization SubpartNo
Authorized OfficialDaniel KhodabakhshCeo / Medical Director · (661) 247-8345
Enumeration DateJanuary 29, 2025
NPPES CertifiedJanuary 29, 2025
NPI 1114730553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyHospice Care, Community BasedAgencies
Taxonomy Code251G00000X
1505 W AVENUE J STE 303, Lancaster, CA 93534

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2162644

Antelope Valley Supportive Care And Hospice, Inc · Lancaster, CA
Active · expires Feb 26, 2027
CLIA Number05D2162644
Laboratory TypeHospice
Certificate Effective DateFebruary 27, 2025
Certificate Expiration DateFebruary 26, 2027
Laboratory DirectorDaniel B. Khodabakhsh
Laboratory Phone(661) 247-8345
Laboratory LocationAntelope Valley Supportive Care And Hospice, Inc1505 West Ave J, Ste 303, Lancaster, CA 93534
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Hospice Care, Community Based
1505 W AVENUE J STE 303
LANCASTER, CA 93534

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Antelope Valley Supportive Care And Hospice Non-Profit's NPI number?

The NPI number for Antelope Valley Supportive Care And Hospice Non-Profit is 1114730553. It was assigned to this organization in the NPPES registry on January 29, 2025.

Where is Antelope Valley Supportive Care And Hospice Non-Profit located?

Antelope Valley Supportive Care And Hospice Non-Profit is located at 1505 W Avenue J Ste 303, Lancaster, CA 93534. The listed phone number is (661) 247-8345.

What is Antelope Valley Supportive Care And Hospice Non-Profit's specialty?

The primary specialty registered for this NPI is Hospice Care, Community Based with taxonomy code 251G00000X.

Does Antelope Valley Supportive Care And Hospice Non-Profit hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2162644) is associated with this NPI, valid through February 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Antelope Valley Supportive Care And Hospice Non-Profit was last updated on January 29, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.