Provider Demographics
NPI:1225422611
Name:BREEZE OF LIFE INC
Entity Type:Organization
Organization Name:BREEZE OF LIFE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMIRCHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-396-5776
Mailing Address - Street 1:28001 SMYTH DR.
Mailing Address - Street 2:SUITE108
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4033
Mailing Address - Country:US
Mailing Address - Phone:661-775-4957
Mailing Address - Fax:
Practice Address - Street 1:412 W BROADWAY STE 202
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1297
Practice Address - Country:US
Practice Address - Phone:818-396-5776
Practice Address - Fax:818-396-5778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based