Provider Demographics
NPI:1437446366
Name:KMD HOSPICE, INC.
Entity Type:Organization
Organization Name:KMD HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYADJYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-504-2419
Mailing Address - Street 1:8133 SAN FERNANDO RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-4005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8133 SAN FERNANDO RD.
Practice Address - Street 2:SUITE E
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-4005
Practice Address - Country:US
Practice Address - Phone:818-504-2419
Practice Address - Fax:818-504-9306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based