Healthcare Provider Details

I. General information

NPI: 1649846312
Provider Name (Legal Business Name): SAXLAVA HOSPICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7050 OWENSMOUTH AVE STE 208
CANOGA PARK CA
91303-4209
US

IV. Provider business mailing address

7050 OWENSMOUTH AVE STE 208
CANOGA PARK CA
91303-4209
US

V. Phone/Fax

Practice location:
  • Phone: 818-722-3331
  • Fax: 818-714-7176
Mailing address:
  • Phone: 818-722-3331
  • Fax: 818-714-7176

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: KHACHIK TANDRATSYAN
Title or Position: CEO
Credential:
Phone: 818-722-3331