Provider Demographics
NPI:1285208413
Name:LOVING DEARLY HOSPICE, INC.
Entity Type:Organization
Organization Name:LOVING DEARLY HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VAGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMBARTSUMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-248-9124
Mailing Address - Street 1:155 W WASHINGTON BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3552
Mailing Address - Country:US
Mailing Address - Phone:323-248-9124
Mailing Address - Fax:323-248-9172
Practice Address - Street 1:155 W WASHINGTON BLVD STE 103
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3552
Practice Address - Country:US
Practice Address - Phone:323-248-9124
Practice Address - Fax:323-248-9172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based