Provider Demographics
NPI:1881266310
Name:FOUR SEASONS HOSPICE, INC.
Entity type:Organization
Organization Name:FOUR SEASONS HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:GUPILAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-572-5537
Mailing Address - Street 1:1241 S GLENDALE AVE STE 301B
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-3386
Mailing Address - Country:US
Mailing Address - Phone:747-300-0562
Mailing Address - Fax:747-300-0563
Practice Address - Street 1:1241 S GLENDALE AVE STE 301B
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-3386
Practice Address - Country:US
Practice Address - Phone:747-300-0562
Practice Address - Fax:747-300-0563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based