Provider Demographics
NPI:1013591072
Name:CA SOLACE HOSPICE INC
Entity Type:Organization
Organization Name:CA SOLACE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANI
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAKARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-528-2970
Mailing Address - Street 1:6032 1/2 VINELAND AVE
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-4912
Mailing Address - Country:US
Mailing Address - Phone:323-528-2970
Mailing Address - Fax:
Practice Address - Street 1:6032 1/2 VINELAND AVE
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4912
Practice Address - Country:US
Practice Address - Phone:323-528-2970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based