Organization Name: | ANGELS LIGHT HOSPICE |
NPI Number: | 1083099931 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KHACHIK GRIGORIAN (CEO) |
Mailing Address: | 4250 Pennsylvania Ave Ste 202 La Crescenta |
State: | CA US |
Postal Code: | 912143369 |
Phone Number: | 8182499933 |
Fax Number: | 8182499005 |
NPI Enumeration Date: | 07/21/2015 |
NPI Last Update Date: | 07/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |