Provider Demographics
NPI:1497364921
Name:GRAND HOSPICE INC
Entity type:Organization
Organization Name:GRAND HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDRANIK
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-200-8598
Mailing Address - Street 1:229 N CENTRAL AVE STE 601
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-3529
Mailing Address - Country:US
Mailing Address - Phone:747-200-8598
Mailing Address - Fax:
Practice Address - Street 1:229 N CENTRAL AVE STE 601
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3529
Practice Address - Country:US
Practice Address - Phone:747-200-8598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based