Healthcare Provider Details

I. General information

NPI: 1205297314
Provider Name (Legal Business Name): MOONLIGHT HOSPICE CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2016
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 E OLIVE AVE SUITE J
BURBANK CA
91502-1235
US

IV. Provider business mailing address

348 E OLIVE AVE STE J
BURBANK CA
91502-1226
US

V. Phone/Fax

Practice location:
  • Phone: 818-429-0797
  • Fax:
Mailing address:
  • Phone: 424-209-9799
  • Fax: 818-337-1723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: HRIPSIME CHILIAN
Title or Position: CEO
Credential:
Phone: 818-429-0797