Provider Demographics
NPI:1750984811
Name:QUALICARE HOSPICE, INC.
Entity type:Organization
Organization Name:QUALICARE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAMO
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVSHADYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-433-5477
Mailing Address - Street 1:502 W ROUTE 66 STE 24
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4379
Mailing Address - Country:US
Mailing Address - Phone:818-433-4577
Mailing Address - Fax:818-484-3707
Practice Address - Street 1:502 W ROUTE 66 STE 24
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4379
Practice Address - Country:US
Practice Address - Phone:818-433-4577
Practice Address - Fax:818-484-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based