Provider Demographics
NPI:1700461175
Name:STARLIGHT HOSPICE CARE INC.
Entity Type:Organization
Organization Name:STARLIGHT HOSPICE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARDANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-408-2155
Mailing Address - Street 1:430 S GARFIELD AVE STE 328
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3876
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:430 S GARFIELD AVE STE 328
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3876
Practice Address - Country:US
Practice Address - Phone:626-408-2155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based