Provider Demographics
NPI:1982205407
Name:A & T HOSPICE
Entity Type:Organization
Organization Name:A & T HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TALLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIROSSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-708-0496
Mailing Address - Street 1:401 N BRAND BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-4443
Mailing Address - Country:US
Mailing Address - Phone:626-708-0496
Mailing Address - Fax:
Practice Address - Street 1:401 N BRAND BLVD STE 240
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-4443
Practice Address - Country:US
Practice Address - Phone:626-708-0496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based