Provider Demographics
NPI:1689049678
Name:ARCLIGHT HOSPICE, INC.
Entity Type:Organization
Organization Name:ARCLIGHT HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARTUR
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALATYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-777-9545
Mailing Address - Street 1:19562 VENTURA BLVD STE 229
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-7126
Mailing Address - Country:US
Mailing Address - Phone:747-777-9545
Mailing Address - Fax:747-777-9546
Practice Address - Street 1:19562 VENTURA BLVD STE 229
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-7126
Practice Address - Country:US
Practice Address - Phone:747-777-9545
Practice Address - Fax:747-777-9546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based