Provider Demographics
NPI:1750963666
Name:FOUR LIFE HOSPICE CARE, INC.
Entity type:Organization
Organization Name:FOUR LIFE HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GARIK
Authorized Official - Middle Name:
Authorized Official - Last Name:KRKHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-509-4392
Mailing Address - Street 1:107181/2 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91602
Mailing Address - Country:US
Mailing Address - Phone:818-509-4392
Mailing Address - Fax:
Practice Address - Street 1:107181/2 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602
Practice Address - Country:US
Practice Address - Phone:818-509-4392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based