Provider Demographics
NPI:1083018931
Name:MIRACLE CARE HOSPICE INC.
Entity Type:Organization
Organization Name:MIRACLE CARE HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HAIK
Authorized Official - Middle Name:
Authorized Official - Last Name:TSATURYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-672-2410
Mailing Address - Street 1:12011 VICTORY BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3330
Mailing Address - Country:US
Mailing Address - Phone:818-672-2410
Mailing Address - Fax:818-301-0380
Practice Address - Street 1:12011 VICTORY BLVD STE 206
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3330
Practice Address - Country:US
Practice Address - Phone:818-672-2410
Practice Address - Fax:818-301-0380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based