Provider Demographics
NPI:1265039234
Name:SAINT MARYAM HOSPICE CARE
Entity Type:Organization
Organization Name:SAINT MARYAM HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LIPARIT
Authorized Official - Middle Name:
Authorized Official - Last Name:GHARIBYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-500-0052
Mailing Address - Street 1:12500 RIVERSIDE DR UNIT 201E
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3423
Mailing Address - Country:US
Mailing Address - Phone:209-500-0052
Mailing Address - Fax:209-500-0053
Practice Address - Street 1:12500 RIVERSIDE DR UNIT 201E
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3423
Practice Address - Country:US
Practice Address - Phone:209-500-0052
Practice Address - Fax:209-500-0053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based