Provider Demographics
NPI:1831774942
Name:VITA HOSPICE INC
Entity type:Organization
Organization Name:VITA HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHBAZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-794-9099
Mailing Address - Street 1:14545 FRIAR ST STE 333
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2397
Mailing Address - Country:US
Mailing Address - Phone:818-794-9099
Mailing Address - Fax:818-936-0760
Practice Address - Street 1:14545 FRIAR ST STE 333
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2397
Practice Address - Country:US
Practice Address - Phone:818-794-9099
Practice Address - Fax:818-936-0760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based