Provider Demographics
NPI:1407380256
Name:CALABASAS CARE HOSPICE INC.
Entity Type:Organization
Organization Name:CALABASAS CARE HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FARIBORS
Authorized Official - Middle Name:
Authorized Official - Last Name:ETTILEIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-397-0440
Mailing Address - Street 1:22949 VENTURA BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1245
Mailing Address - Country:US
Mailing Address - Phone:818-397-0440
Mailing Address - Fax:818-450-0503
Practice Address - Street 1:22949 VENTURA BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1245
Practice Address - Country:US
Practice Address - Phone:818-397-0440
Practice Address - Fax:818-450-0503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based