Provider Demographics
NPI:1649688821
Name:BLUE SPIRIT HOSPICE, INC.
Entity type:Organization
Organization Name:BLUE SPIRIT HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRINIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-463-4604
Mailing Address - Street 1:1110N WESTERN AVE #208
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029
Mailing Address - Country:US
Mailing Address - Phone:323-463-4604
Mailing Address - Fax:323-463-4605
Practice Address - Street 1:1110 N WESTERN AVE STE 208
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1087
Practice Address - Country:US
Practice Address - Phone:323-463-4604
Practice Address - Fax:323-463-4605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient