Healthcare Provider Details

I. General information

NPI: 1841424140
Provider Name (Legal Business Name): GUARDIAN SPIRIT HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2009
Last Update Date: 10/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2117 LAKE AVE DUITE 201
ALTADENA CA
91001-2462
US

IV. Provider business mailing address

2117N LAKE AVE SUITE 201
ALTADENA CA
91001-2462
US

V. Phone/Fax

Practice location:
  • Phone: 323-913-0288
  • Fax: 323-913-0268
Mailing address:
  • Phone: 323-913-0288
  • Fax: 323-913-0268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MARGARIT HOVHANNISYAN
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 323-913-0288