Provider Demographics
NPI:1275159303
Name:CREST HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:CREST HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIKUCHUKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-279-6772
Mailing Address - Street 1:121 W LEXINGTON DR STE 512
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2230
Mailing Address - Country:US
Mailing Address - Phone:747-279-6776
Mailing Address - Fax:
Practice Address - Street 1:121 W LEXINGTON DR STE 512
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2230
Practice Address - Country:US
Practice Address - Phone:747-279-6776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based