Provider Demographics
NPI:1952982324
Name:ROOF GARDEN HOSPICE CARE INC
Entity Type:Organization
Organization Name:ROOF GARDEN HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOVSISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-282-0474
Mailing Address - Street 1:9871 SAN FERNANDO RD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:PACOIMA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-2693
Mailing Address - Country:US
Mailing Address - Phone:747-282-0474
Mailing Address - Fax:
Practice Address - Street 1:9871 SAN FERNANDO RD UNIT 1
Practice Address - Street 2:
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-2693
Practice Address - Country:US
Practice Address - Phone:747-282-0474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-17
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based