Healthcare Provider Details
I. General information
NPI: 1750996906
Provider Name (Legal Business Name): HOSPICE OF 1ST CHOICE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2020
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7311 VAN NUYS BLVD UNIT 15
VAN NUYS CA
91405-1958
US
IV. Provider business mailing address
7311 VAN NUYS BLVD UNIT 15
VAN NUYS CA
91405-1958
US
V. Phone/Fax
- Phone: 747-205-1377
- Fax: 818-241-5859
- Phone: 747-205-1377
- Fax: 818-241-5859
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MR.
ARTUR
GRIGORYAN
Title or Position: MANAGER
Credential:
Phone: 747-205-1377