Provider Demographics
NPI:1851678916
Name:HOSPICE OF ST. CLARE, INC.
Entity Type:Organization
Organization Name:HOSPICE OF ST. CLARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMVALIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-243-9999
Mailing Address - Street 1:144 N GLENDALE AVE #222
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4903
Mailing Address - Country:US
Mailing Address - Phone:818-508-8500
Mailing Address - Fax:818-508-8501
Practice Address - Street 1:144 N GLENDALE AVE #222
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4903
Practice Address - Country:US
Practice Address - Phone:818-508-8500
Practice Address - Fax:818-508-8501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based