Provider Demographics
NPI:1710383617
Name:MIRACLE HEALING HOSPICE, INC.
Entity Type:Organization
Organization Name:MIRACLE HEALING HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO
Authorized Official - Prefix:
Authorized Official - First Name:AKOP
Authorized Official - Middle Name:
Authorized Official - Last Name:EKIMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-400-9586
Mailing Address - Street 1:13609-13615 VICTORY BLVD
Mailing Address - Street 2:STE #222 & 223
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-1736
Mailing Address - Country:US
Mailing Address - Phone:818-400-9586
Mailing Address - Fax:
Practice Address - Street 1:13609-13615 VICTORY BLVD
Practice Address - Street 2:STE #222 & 223
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1736
Practice Address - Country:US
Practice Address - Phone:818-400-9586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based