Provider Demographics
NPI:1659959187
Name:WELL WISE HOSPICE
Entity Type:Organization
Organization Name:WELL WISE HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SASOON
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSEFIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-731-4447
Mailing Address - Street 1:100 N BARRANCA ST STE 714
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1647
Mailing Address - Country:US
Mailing Address - Phone:818-731-4447
Mailing Address - Fax:
Practice Address - Street 1:100 N BARRANCA ST STE 714
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1647
Practice Address - Country:US
Practice Address - Phone:818-731-4447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based