Provider Demographics
NPI:1710314752
Name:TOLUCA HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:TOLUCA HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:VAHAGN
Authorized Official - Middle Name:V
Authorized Official - Last Name:SEROBYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-754-1213
Mailing Address - Street 1:4418 VINELAND AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91602-3457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4418 VINELAND AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:TOLUCA LAKE
Practice Address - State:CA
Practice Address - Zip Code:91602-3457
Practice Address - Country:US
Practice Address - Phone:818-754-1213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550002139251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based