Provider Demographics
NPI:1093080921
Name:GL HOSPICE CARE, INCORPORATION
Entity Type:Organization
Organization Name:GL HOSPICE CARE, INCORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEVORKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-742-6490
Mailing Address - Street 1:6931 VAN NUYS BLVD
Mailing Address - Street 2:#323
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-3937
Mailing Address - Country:US
Mailing Address - Phone:818-742-6490
Mailing Address - Fax:818-742-6491
Practice Address - Street 1:6931 VAN NUYS BLVD
Practice Address - Street 2:#323
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3937
Practice Address - Country:US
Practice Address - Phone:818-742-6490
Practice Address - Fax:818-742-6491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-10
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based