Provider Demographics
NPI:1639764301
Name:GRANDCARE HOSPICE INC
Entity Type:Organization
Organization Name:GRANDCARE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARKIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MINASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-683-2208
Mailing Address - Street 1:6906 MATILIJA AVE
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-4157
Mailing Address - Country:US
Mailing Address - Phone:323-333-3542
Mailing Address - Fax:
Practice Address - Street 1:10235 SEPULVEDA BLVD UNIT A
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-2639
Practice Address - Country:US
Practice Address - Phone:818-683-2208
Practice Address - Fax:818-683-2209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based