Provider Demographics
NPI:1215535299
Name:SELECTIVE HOSPICE INC
Entity Type:Organization
Organization Name:SELECTIVE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVSEPYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-240-3075
Mailing Address - Street 1:11712 MOORPARK ST STE 212B
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2154
Mailing Address - Country:US
Mailing Address - Phone:747-240-3075
Mailing Address - Fax:
Practice Address - Street 1:11712 MOORPARK ST STE 212B
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2154
Practice Address - Country:US
Practice Address - Phone:747-240-3075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based