Provider Demographics
NPI:1396359485
Name:TRG HOSPICE, INC.
Entity Type:Organization
Organization Name:TRG HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIGRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VASILYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-616-8168
Mailing Address - Street 1:7034 VAN NUYS BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-3060
Mailing Address - Country:US
Mailing Address - Phone:818-616-8168
Mailing Address - Fax:
Practice Address - Street 1:7034 VAN NUYS BLVD STE 205
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3060
Practice Address - Country:US
Practice Address - Phone:818-616-8168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based