Provider Demographics
NPI:1609287804
Name:CITY OF ANGELS HOSPICE CARE
Entity Type:Organization
Organization Name:CITY OF ANGELS HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TARON
Authorized Official - Middle Name:
Authorized Official - Last Name:OGANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-524-8605
Mailing Address - Street 1:111 GLENDALE BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-5825
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 GLENDALE BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-5825
Practice Address - Country:US
Practice Address - Phone:818-524-8605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-11
Last Update Date:2014-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based