Provider Demographics
NPI:1700452059
Name:GREEN PATH HOSPICE CARE OF LA INC
Entity Type:Organization
Organization Name:GREEN PATH HOSPICE CARE OF LA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:AVAKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-374-0544
Mailing Address - Street 1:13615 VICTORY BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-1761
Mailing Address - Country:US
Mailing Address - Phone:424-374-0544
Mailing Address - Fax:
Practice Address - Street 1:13615 VICTORY BLVD STE 214
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1761
Practice Address - Country:US
Practice Address - Phone:424-374-0544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based