Provider Demographics
NPI:1982200028
Name:CA VALLEY HOSPICE, INC
Entity Type:Organization
Organization Name:CA VALLEY HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARTYOM
Authorized Official - Middle Name:
Authorized Official - Last Name:TUMASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-725-6521
Mailing Address - Street 1:18747 SHERMAN WAY STE 111
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4000
Mailing Address - Country:US
Mailing Address - Phone:818-725-6521
Mailing Address - Fax:
Practice Address - Street 1:18747 SHERMAN WAY STE 111
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4000
Practice Address - Country:US
Practice Address - Phone:818-725-6521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based