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NPI 1477132900

NPI 1477132900 : MIX CARE LA HOSPICE, INC. : SHERMAN OAKS, CA

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General NPI Number Information
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    NPI Number           |    1477132900
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    Entity Type          |    Organization 
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    Legal Business Name  |    MIX CARE LA HOSPICE, INC. 
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Dates
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    Enumeration Date     |    04/02/2021
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    Last Update Date     |    04/02/2021
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Provider Practice Location Address
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    Address Line         |    14242 VENTURA BLVD STE 211 
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    City                 |    SHERMAN OAKS
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    State                |    CA
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    Zip                  |    91423-2757
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    Country              |    US
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    Telephone            |    323-443-6633
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    14242 VENTURA BLVD STE 211 
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    City                 |    SHERMAN OAKS
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    State                |    CA
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    Zip                  |    91423-2757
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    Country              |    US
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    Telephone            |    323-443-6633
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     ALEK  TOROSYAN 
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    Credential           |    
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    Telephone            |    323-443-6633
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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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