| Organization Name: | ST. NICOLAS HOSPICE CARE, INC. |
| NPI Number: | 1356616965 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NARINE AVAGYAN (CEO/PRESIDENT) |
| Mailing Address: | 2529 Foothill Blvd Suite 1 La Crescenta |
| State: | CA US |
| Postal Code: | 912143521 |
| Phone Number: | 8186669344 |
| Fax Number: | 8002509813 |
| NPI Enumeration Date: | 03/14/2012 |
| NPI Last Update Date: | 10/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |