Provider Demographics
NPI:1396896866
Name:PARADISE HOSPICE INC
Entity type:Organization
Organization Name:PARADISE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VARSENIK
Authorized Official - Middle Name:VICKI
Authorized Official - Last Name:OGANESYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-794-1050
Mailing Address - Street 1:1864 E WASHINGTON BLVD
Mailing Address - Street 2:#207
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-1666
Mailing Address - Country:US
Mailing Address - Phone:626-376-2675
Mailing Address - Fax:
Practice Address - Street 1:1864 E WASHINGTON BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-1666
Practice Address - Country:US
Practice Address - Phone:626-794-1050
Practice Address - Fax:626-794-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-13
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
551599Medicare Oscar/Certification