Provider Demographics
NPI:1003496134
Name:SPLENDOR HOSPICE AND PALLIATIVE CARE, LLC
Entity Type:Organization
Organization Name:SPLENDOR HOSPICE AND PALLIATIVE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-C/ DPCS/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDEN
Authorized Official - Middle Name:BABARAN
Authorized Official - Last Name:DABALUS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:818-812-9753
Mailing Address - Street 1:8619 RESEDA BLVD STE 201A
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4044
Mailing Address - Country:US
Mailing Address - Phone:818-812-9753
Mailing Address - Fax:818-301-2541
Practice Address - Street 1:8619 RESEDA BLVD STE 201A
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4044
Practice Address - Country:US
Practice Address - Phone:818-812-9753
Practice Address - Fax:818-301-2541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based