Provider Demographics
NPI:1770245730
Name:PEACEFUL CARE HOSPICE
Entity Type:Organization
Organization Name:PEACEFUL CARE HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KHACHATRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-552-3300
Mailing Address - Street 1:11565 YARMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-2102
Mailing Address - Country:US
Mailing Address - Phone:352-552-3300
Mailing Address - Fax:515-864-0220
Practice Address - Street 1:699 WALNUT ST STE 422
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-3929
Practice Address - Country:US
Practice Address - Phone:352-552-3300
Practice Address - Fax:515-864-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based