Provider Demographics
NPI:1639725021
Name:MADISON HOSPICE, INC.
Entity Type:Organization
Organization Name:MADISON HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGAJANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-435-7800
Mailing Address - Street 1:229 N CENTRAL AVE # 207
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-3507
Mailing Address - Country:US
Mailing Address - Phone:818-435-7800
Mailing Address - Fax:818-574-4050
Practice Address - Street 1:229 N CENTRAL AVE STE 207
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3507
Practice Address - Country:US
Practice Address - Phone:818-435-7800
Practice Address - Fax:818-574-4050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health