Provider Demographics
NPI:1891160255
Name:MIRACLE HOSPICE AND PALLIATIVE CARE, INC.
Entity Type:Organization
Organization Name:MIRACLE HOSPICE AND PALLIATIVE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ARMENUI
Authorized Official - Middle Name:
Authorized Official - Last Name:MILITONYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-358-2668
Mailing Address - Street 1:11486 BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-2301
Mailing Address - Country:US
Mailing Address - Phone:818-358-2668
Mailing Address - Fax:818-358-2528
Practice Address - Street 1:11486 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-2301
Practice Address - Country:US
Practice Address - Phone:818-358-2668
Practice Address - Fax:818-358-2528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based