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General NPI Number Information
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NPI Number | 1356616965
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Entity Type | Organization
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Legal Business Name | ST. NICOLAS HOSPICE CARE, INC.
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Dates
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Enumeration Date | 03/14/2012
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 2529 FOOTHILL BLVD SUITE 1
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City | LA CRESCENTA
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State | CA
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Zip | 91214-3521
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Country | US
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Telephone | 818-666-9344
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Fax | 800-250-9813
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Provider Business Mailing Address
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Address Line | 2529 FOOTHILL BLVD SUITE 1
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City | LA CRESCENTA
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State | CA
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Zip | 91214-3521
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Country | US
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Telephone | 818-666-9344
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Fax | 800-250-9813
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MS. NARINE AVAGYAN
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Credential |
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Telephone | 818-666-9344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 550002291
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License Number State | CA
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