Provider Demographics
NPI:1184262842
Name:SUPERB HOSPICE INC
Entity type:Organization
Organization Name:SUPERB HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO/SEC/BM
Authorized Official - Prefix:MRS
Authorized Official - First Name:GOHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-216-2288
Mailing Address - Street 1:14545 FRIAR ST
Mailing Address - Street 2:STE 170
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2397
Mailing Address - Country:US
Mailing Address - Phone:818-646-1910
Mailing Address - Fax:818-646-1909
Practice Address - Street 1:14545 FRIAR ST
Practice Address - Street 2:SUITE 170
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2397
Practice Address - Country:US
Practice Address - Phone:818-646-1910
Practice Address - Fax:818-646-1909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based