Provider Demographics
NPI:1881361038
Name:LIFE HOUSE HOSPICEINC
Entity type:Organization
Organization Name:LIFE HOUSE HOSPICEINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGOPIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:323-401-0508
Mailing Address - Street 1:1005 N SCREENLAND DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2502
Mailing Address - Country:US
Mailing Address - Phone:323-401-0508
Mailing Address - Fax:
Practice Address - Street 1:1005 N SCREENLAND DR
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2502
Practice Address - Country:US
Practice Address - Phone:323-401-0508
Practice Address - Fax:818-848-8905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based