Provider Demographics
NPI:1588216816
Name:BROOKDALE HOSPICE, INC.
Entity Type:Organization
Organization Name:BROOKDALE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRIELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-351-5771
Mailing Address - Street 1:3089 N. LIMA ST.
Mailing Address - Street 2:UNIT # F
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2013
Mailing Address - Country:US
Mailing Address - Phone:818-351-5771
Mailing Address - Fax:818-351-5774
Practice Address - Street 1:3089 N. LIMA ST. # F
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502
Practice Address - Country:US
Practice Address - Phone:818-351-5771
Practice Address - Fax:818-351-5474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health