Healthcare Provider Details

I. General information

NPI: 1265079685
Provider Name (Legal Business Name): LAVILA HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2019
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 ARDEN AVE STE 205
GLENDALE CA
91203-4056
US

IV. Provider business mailing address

327 ARDEN AVE STE 205
GLENDALE CA
91203-4056
US

V. Phone/Fax

Practice location:
  • Phone: 747-247-0570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: LARISA DURGARYAN
Title or Position: CEO
Credential:
Phone: 747-247-0570