Provider Demographics
NPI:1104384601
Name:ADVENTIST HOSPICE CARE,INC.
Entity Type:Organization
Organization Name:ADVENTIST HOSPICE CARE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NIKOLAY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLABYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-691-1316
Mailing Address - Street 1:14549 ARCHWOOD ST STE 202
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-4633
Mailing Address - Country:US
Mailing Address - Phone:818-691-1316
Mailing Address - Fax:818-671-1868
Practice Address - Street 1:14549 ARCHWOOD ST STE 202
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4633
Practice Address - Country:US
Practice Address - Phone:818-691-1316
Practice Address - Fax:818-671-1868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based