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General NPI Number Information
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NPI Number | 1649688821
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Entity Type | Organization
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Legal Business Name | BLUE SPIRIT HOSPICE, INC.
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 1110 N WESTERN AVE STE 208
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City | LOS ANGELES
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State | CA
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Zip | 90029-1087
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Country | US
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Telephone | 323-463-4604
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Fax | 323-463-4605
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Provider Business Mailing Address
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Address Line | 1110N WESTERN AVE #208
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City | LOS ANGELES
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State | CA
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Zip | 90029
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Country | US
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Telephone | 323-463-4604
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Fax | 323-463-4605
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Authorized Official
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Title or Position | CEO
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Name | MS. SOSE SHIRINIAN
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Credential |
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Telephone | 323-463-4604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number |
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License Number State |
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