Provider Demographics
NPI:1376194878
Name:ST. ANGEL HOSPICE
Entity Type:Organization
Organization Name:ST. ANGEL HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MKRTCHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-480-3587
Mailing Address - Street 1:401 N BRAND BLVD UNIT 354
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-4427
Mailing Address - Country:US
Mailing Address - Phone:818-480-3587
Mailing Address - Fax:818-484-2818
Practice Address - Street 1:401 N BRAND BLVD UNIT 354
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-4427
Practice Address - Country:US
Practice Address - Phone:818-480-3587
Practice Address - Fax:818-484-2818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based