Provider Demographics
NPI:1558761833
Name:MINDBODY HOSPICE INC
Entity Type:Organization
Organization Name:MINDBODY HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:LAURENT
Authorized Official - Last Name:VOSKANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-777-6463
Mailing Address - Street 1:30101 AGOURA CT
Mailing Address - Street 2:STE 123
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4300
Mailing Address - Country:US
Mailing Address - Phone:844-777-6463
Mailing Address - Fax:833-790-3894
Practice Address - Street 1:30101 AGOURA CT
Practice Address - Street 2:STE 123
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4300
Practice Address - Country:US
Practice Address - Phone:844-777-6463
Practice Address - Fax:833-790-3894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based