Provider Demographics
NPI:1275816969
Name:COMMUNITY HOSPICE CARE LLC
Entity Type:Organization
Organization Name:COMMUNITY HOSPICE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVRETSKY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:818-205-9030
Mailing Address - Street 1:17141 VENTURA BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4036
Mailing Address - Country:US
Mailing Address - Phone:818-205-9030
Mailing Address - Fax:
Practice Address - Street 1:17141 VENTURA BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4036
Practice Address - Country:US
Practice Address - Phone:818-205-9030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-20
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based