Provider Demographics
NPI:1891360897
Name:WISDOM HOSPICE CARE INC
Entity Type:Organization
Organization Name:WISDOM HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MKRTCHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-484-0828
Mailing Address - Street 1:227 N CENTRAL AVE
Mailing Address - Street 2:UNIT 101
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203
Mailing Address - Country:US
Mailing Address - Phone:818-484-0828
Mailing Address - Fax:
Practice Address - Street 1:227 N CENTRAL AVE
Practice Address - Street 2:UNIT 101
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203
Practice Address - Country:US
Practice Address - Phone:818-484-0828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based