Provider Demographics
NPI:1740777051
Name:ODYSSEY HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:ODYSSEY HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:O
Authorized Official - Last Name:MEHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:981-832-4918
Mailing Address - Street 1:9017 RESEDA BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-3979
Mailing Address - Country:US
Mailing Address - Phone:818-324-9185
Mailing Address - Fax:818-344-2171
Practice Address - Street 1:9017 RESEDA BLVD STE 211
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-3979
Practice Address - Country:US
Practice Address - Phone:818-324-9185
Practice Address - Fax:818-344-2171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based