Provider Demographics
NPI:1649844960
Name:SELECTED HOSPICE, INC
Entity type:Organization
Organization Name:SELECTED HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AGAZARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-850-4780
Mailing Address - Street 1:10545 BURBANK BLVD.
Mailing Address - Street 2:SUITE 132
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-2249
Mailing Address - Country:US
Mailing Address - Phone:818-850-4780
Mailing Address - Fax:818-736-9008
Practice Address - Street 1:10545 BURBANK BLVD.
Practice Address - Street 2:SUITE 132
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-2249
Practice Address - Country:US
Practice Address - Phone:818-850-4780
Practice Address - Fax:818-736-9008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health