=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821415100
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EVEREST HOSPICE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/25/2014
-----------------------------------------------------
Last Update Date | 01/03/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6047 TAMPA AVE STE 203
-----------------------------------------------------
City | TARZANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91356-1191
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-778-5404
-----------------------------------------------------
Fax | 818-671-1888
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6047 TAMPA AVE STE 203
-----------------------------------------------------
City | TARZANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91356-1191
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-778-5404
-----------------------------------------------------
Fax | 818-671-1888
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MISS MILENA MELKONYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 888-778-5404
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------