Provider Demographics
NPI:1033265855
Name:HOSPICE OF ST. RITA, INC.
Entity Type:Organization
Organization Name:HOSPICE OF ST. RITA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEVORK
Authorized Official - Middle Name:
Authorized Official - Last Name:TER-STEPANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-765-0088
Mailing Address - Street 1:13363 SATICOY ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-3400
Mailing Address - Country:US
Mailing Address - Phone:818-765-0088
Mailing Address - Fax:818-765-0044
Practice Address - Street 1:13363 SATICOY ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-3400
Practice Address - Country:US
Practice Address - Phone:818-765-0088
Practice Address - Fax:818-765-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551577Medicare Oscar/Certification