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General NPI Number Information
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NPI Number | 1437745643
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Entity Type | Organization
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Legal Business Name | GREEN PATH HOSPICE, INC.
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Dates
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Enumeration Date | 12/12/2020
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Last Update Date | 12/12/2020
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Provider Practice Location Address
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Address Line | 2600 W OLIVE AVE STE 523
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City | BURBANK
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State | CA
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Zip | 91505-4549
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Country | US
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Telephone | 747-262-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 W OLIVE AVE STE 523
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City | BURBANK
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State | CA
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Zip | 91505-4549
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Country | US
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Telephone | 747-262-7575
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Fax |
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Authorized Official
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Title or Position | CEO/PRES.
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Name | DIANA SHATS
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Credential |
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Telephone | 818-970-3914
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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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