Provider Demographics
NPI:1215604277
Name:HEAVEN N SOUL HOSPICE INC
Entity Type:Organization
Organization Name:HEAVEN N SOUL HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMBARTSUMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-877-2480
Mailing Address - Street 1:12444 VICTORY BLVD STE 301-0
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3199
Mailing Address - Country:US
Mailing Address - Phone:747-877-2480
Mailing Address - Fax:747-877-2483
Practice Address - Street 1:12444 VICTORY BLVD STE 301-0
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3199
Practice Address - Country:US
Practice Address - Phone:747-877-2480
Practice Address - Fax:747-877-2483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based