Provider Demographics
NPI:1013496207
Name:NICOLETTE HOSPICE, INC.
Entity Type:Organization
Organization Name:NICOLETTE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GYANDZHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-293-9155
Mailing Address - Street 1:444 IRVING DRIVE
Mailing Address - Street 2:SUITE 201C
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2415
Mailing Address - Country:US
Mailing Address - Phone:818-293-9155
Mailing Address - Fax:818-301-3138
Practice Address - Street 1:444 IRVING DRIVE
Practice Address - Street 2:SUITE 201C
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-2415
Practice Address - Country:US
Practice Address - Phone:818-293-9155
Practice Address - Fax:818-301-3138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-09
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health