Provider Demographics
NPI:1811302664
Name:GRIGMAR HOSPICE AND PALLIATIVE CARE, INC.
Entity type:Organization
Organization Name:GRIGMAR HOSPICE AND PALLIATIVE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGORYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-401-1616
Mailing Address - Street 1:14640 VICTORY BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1623
Mailing Address - Country:US
Mailing Address - Phone:323-401-1616
Mailing Address - Fax:
Practice Address - Street 1:14640 VICTORY BLVD
Practice Address - Street 2:STE 208
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1623
Practice Address - Country:US
Practice Address - Phone:323-401-1616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based