Provider Demographics
NPI:1568044683
Name:VALLEY FRIENDLY HOSPICE CORP
Entity Type:Organization
Organization Name:VALLEY FRIENDLY HOSPICE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VYACHESLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-200-0143
Mailing Address - Street 1:6032 VINELAND AVE
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-4912
Mailing Address - Country:US
Mailing Address - Phone:424-200-0143
Mailing Address - Fax:
Practice Address - Street 1:6032 VINELAND AVE
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4912
Practice Address - Country:US
Practice Address - Phone:424-200-0143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based