Provider Demographics
NPI:1982961504
Name:AMENITY HOSPICE CARE OF LOS ANGELES,INC.
Entity Type:Organization
Organization Name:AMENITY HOSPICE CARE OF LOS ANGELES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUISA
Authorized Official - Middle Name:TAKOUHI
Authorized Official - Last Name:SEPEDJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-387-4200
Mailing Address - Street 1:3407 W 6TH ST
Mailing Address - Street 2:SUITE 505
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-2537
Mailing Address - Country:US
Mailing Address - Phone:231-387-4200
Mailing Address - Fax:213-387-4205
Practice Address - Street 1:3407 W 6TH ST
Practice Address - Street 2:SUITE 505
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-2537
Practice Address - Country:US
Practice Address - Phone:231-387-4200
Practice Address - Fax:213-387-4205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based