Provider Demographics
NPI:1902374242
Name:ATENA HOSPICE, INC.
Entity Type:Organization
Organization Name:ATENA HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AREVIK
Authorized Official - Middle Name:
Authorized Official - Last Name:GEVORGYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-302-0026
Mailing Address - Street 1:13735 VICTORY BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6736
Mailing Address - Country:US
Mailing Address - Phone:818-302-0026
Mailing Address - Fax:818-208-9318
Practice Address - Street 1:13735 VICTORY BLVD STE 8
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-6736
Practice Address - Country:US
Practice Address - Phone:818-302-0026
Practice Address - Fax:818-208-9318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health