Provider Demographics
NPI:1912518341
Name:GOLDSTONE HOSPICE INC
Entity Type:Organization
Organization Name:GOLDSTONE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARIS
Authorized Official - Middle Name:ALEX
Authorized Official - Last Name:AZDARIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-334-0303
Mailing Address - Street 1:15480 ARROW HWY STE 206
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-1863
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15480 ARROW HWY STE 206
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-1863
Practice Address - Country:US
Practice Address - Phone:818-334-0303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based