Provider Demographics
NPI:1578235370
Name:GRACEFUL NURSING HOSPICE CARE INC
Entity Type:Organization
Organization Name:GRACEFUL NURSING HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CFO/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JULIETA
Authorized Official - Middle Name:
Authorized Official - Last Name:OUSHAKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-500-0145
Mailing Address - Street 1:700 BART EARLE WAY UNIT 204
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3646
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 BART EARLE WAY UNIT 204
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3646
Practice Address - Country:US
Practice Address - Phone:747-500-0145
Practice Address - Fax:747-500-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based