Provider Demographics
NPI:1205415437
Name:LIFESTYLE HOSPICE INC
Entity Type:Organization
Organization Name:LIFESTYLE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SARUKHANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-776-9236
Mailing Address - Street 1:2600 FOOTHILL BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-4578
Mailing Address - Country:US
Mailing Address - Phone:909-776-9236
Mailing Address - Fax:
Practice Address - Street 1:2600 FOOTHILL BLVD STE 110
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-4578
Practice Address - Country:US
Practice Address - Phone:909-776-9236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based