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NPI 1427621283

NPI 1427621283 : SOULISTIC HOSPICE CARE, INC. : LA CRESCENTA, CA

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General NPI Number Information
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    NPI Number           |    1427621283
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    Entity Type          |    Organization 
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    Legal Business Name  |    SOULISTIC HOSPICE CARE, INC. 
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Dates
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    Enumeration Date     |    07/20/2021
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    Last Update Date     |    07/20/2021
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Provider Practice Location Address
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    Address Line         |    3638 FOOTHILL BLVD 
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    City                 |    LA CRESCENTA
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    State                |    CA
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    Zip                  |    91214-1738
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    Country              |    US
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    Telephone            |    747-268-7430
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    Fax                  |    747-268-7433
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Provider Business Mailing Address
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    Address Line         |    3638 FOOTHILL BLVD 
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    City                 |    LA CRESCENTA
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    State                |    CA
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    Zip                  |    91214-1738
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    Country              |    US
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    Telephone            |    747-268-7430
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    Fax                  |    747-268-7433
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     HAKOB  GLNDJIAN 
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    Credential           |    
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    Telephone            |    747-268-7430
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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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