Provider Demographics
NPI:1629346465
Name:GATES TO PARADISE HOSPICE CARE INC
Entity Type:Organization
Organization Name:GATES TO PARADISE HOSPICE CARE INC
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LAERT
Authorized Official - Middle Name:
Authorized Official - Last Name:AYVAZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-885-5503
Mailing Address - Street 1:8700 RESEDA BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4041
Mailing Address - Country:US
Mailing Address - Phone:818-885-5503
Mailing Address - Fax:818-885-5750
Practice Address - Street 1:8700 RESEDA BLVD
Practice Address - Street 2:STE 102
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4041
Practice Address - Country:US
Practice Address - Phone:818-885-5503
Practice Address - Fax:818-885-5750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based