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General NPI Number Information
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NPI Number | 1588288849
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Entity Type | Organization
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Legal Business Name | BLUE RIVER HOSPICE INC
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 171 N ALTADENA DR STE 235
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City | PASADENA
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State | CA
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Zip | 91107-7319
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Country | US
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Telephone | 818-921-3177
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Fax |
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Provider Business Mailing Address
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Address Line | 17620 SHERMAN WAY STE 207
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City | VAN NUYS
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State | CA
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Zip | 91406-3527
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Country | US
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Telephone | 818-254-8845
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ARMEN GASPARIAN
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Credential |
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Telephone | 818-921-3177
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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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