Provider Demographics
NPI:1508011875
Name:SANTA MARGARITA HOSPICE,INC.
Entity Type:Organization
Organization Name:SANTA MARGARITA HOSPICE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GAREGEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEURJEKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-644-7440
Mailing Address - Street 1:3171 LOS FELIZ BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1536
Mailing Address - Country:US
Mailing Address - Phone:323-644-7440
Mailing Address - Fax:323-644-7443
Practice Address - Street 1:3171 LOS FELIZ BLVD STE 206
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1536
Practice Address - Country:US
Practice Address - Phone:323-644-7440
Practice Address - Fax:323-644-7443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient