Provider Demographics
NPI:1326633298
Name:PEACEFUL HAVEN HOSPICE INC.
Entity Type:Organization
Organization Name:PEACEFUL HAVEN HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDUNARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-689-1032
Mailing Address - Street 1:4509 SENDERO PL
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-5129
Mailing Address - Country:US
Mailing Address - Phone:818-689-1032
Mailing Address - Fax:
Practice Address - Street 1:10237 SEPULVEDA BLVD UNIT B
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-2639
Practice Address - Country:US
Practice Address - Phone:818-689-1032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based