Healthcare Provider Details

I. General information

NPI: 1093146672
Provider Name (Legal Business Name): EMANUEL HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2013
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10324 BALBOA BLVD SUITE 203A
GRANADA HILLS CA
91344-7349
US

IV. Provider business mailing address

16925 DEVONSHIRE ST SUITE 390
GRANADA HILLS CA
91344-7407
US

V. Phone/Fax

Practice location:
  • Phone: 818-465-3389
  • Fax: 818-208-9693
Mailing address:
  • Phone: 818-465-3389
  • Fax: 818-208-9693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: STELLA VARDANYAN
Title or Position: CEO
Credential:
Phone: 760-621-0435