Provider Demographics
NPI:1851904270
Name:VITA LUXE HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:VITA LUXE HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-203-9399
Mailing Address - Street 1:417 ARDEN AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-4047
Mailing Address - Country:US
Mailing Address - Phone:747-293-9399
Mailing Address - Fax:747-500-0057
Practice Address - Street 1:417 ARDEN AVE STE 208
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-4047
Practice Address - Country:US
Practice Address - Phone:747-293-9399
Practice Address - Fax:747-500-0057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based