Provider Demographics
NPI:1598349078
Name:SEASON OF LIFE HOSPICE
Entity Type:Organization
Organization Name:SEASON OF LIFE HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASHOT
Authorized Official - Middle Name:
Authorized Official - Last Name:PETROSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-730-1155
Mailing Address - Street 1:121 W LEXINGTON DR STE 202A
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2203
Mailing Address - Country:US
Mailing Address - Phone:818-730-1155
Mailing Address - Fax:818-748-3501
Practice Address - Street 1:121 W LEXINGTON DR STE 202A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2203
Practice Address - Country:US
Practice Address - Phone:818-730-1155
Practice Address - Fax:818-748-3501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based