Provider Demographics
NPI:1871186247
Name:GRAND HEALTH HOSPICE, INC.
Entity Type:Organization
Organization Name:GRAND HEALTH HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEVORG
Authorized Official - Middle Name:
Authorized Official - Last Name:PORSUGHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-358-6050
Mailing Address - Street 1:8932 RESEDA BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-5830
Mailing Address - Country:US
Mailing Address - Phone:818-358-6050
Mailing Address - Fax:818-358-6050
Practice Address - Street 1:6900 CANBY AVE STE 109
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4312
Practice Address - Country:US
Practice Address - Phone:747-265-6601
Practice Address - Fax:818-358-6050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based