Provider Demographics
NPI:1497026959
Name:LOS ROBLES HOSPICE, INC.
Entity type:Organization
Organization Name:LOS ROBLES HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SRBUI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERKEZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-338-5306
Mailing Address - Street 1:2955 E HILLCREST DR
Mailing Address - Street 2:120
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3176
Mailing Address - Country:US
Mailing Address - Phone:805-397-0500
Mailing Address - Fax:805-397-0501
Practice Address - Street 1:2955 E HILLCREST DR
Practice Address - Street 2:120
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3176
Practice Address - Country:US
Practice Address - Phone:805-397-0500
Practice Address - Fax:805-397-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-14
Last Update Date:2012-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based