Provider Demographics
NPI:1780249102
Name:ON TIME HOSPICE CARE INC.
Entity type:Organization
Organization Name:ON TIME HOSPICE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LILIT
Authorized Official - Middle Name:
Authorized Official - Last Name:MOVSISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-260-0047
Mailing Address - Street 1:11133 VANOWEN ST STE D
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-6376
Mailing Address - Country:US
Mailing Address - Phone:747-260-0047
Mailing Address - Fax:
Practice Address - Street 1:3316 W BURBANK BLVD STE A
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2230
Practice Address - Country:US
Practice Address - Phone:747-260-0047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-01
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1Medicaid