Provider Demographics
NPI:1912545930
Name:SERENITY RIDGE PALLIATIVE AND HOSPICE CARE
Entity Type:Organization
Organization Name:SERENITY RIDGE PALLIATIVE AND HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO/SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:AVO
Authorized Official - Middle Name:KRIKOR
Authorized Official - Last Name:HARUTUNIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-217-4436
Mailing Address - Street 1:11239 TAMPA AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-3784
Mailing Address - Country:US
Mailing Address - Phone:818-217-4436
Mailing Address - Fax:818-217-4336
Practice Address - Street 1:11239 TAMPA AVE STE 203
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-3784
Practice Address - Country:US
Practice Address - Phone:818-217-4436
Practice Address - Fax:818-217-4336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based