Provider Demographics
NPI:1407226707
Name:APPLE VALLEY HOSPICE, INC.
Entity type:Organization
Organization Name:APPLE VALLEY HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARNIK
Authorized Official - Middle Name:
Authorized Official - Last Name:GEVORGYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-981-0690
Mailing Address - Street 1:12241 INDUSTRIAL BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-7794
Mailing Address - Country:US
Mailing Address - Phone:760-981-0690
Mailing Address - Fax:760-981-0689
Practice Address - Street 1:12241 INDUSTRIAL BLVD
Practice Address - Street 2:STE 201
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-7794
Practice Address - Country:US
Practice Address - Phone:760-981-0690
Practice Address - Fax:760-981-0689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based