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General NPI Number Information
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NPI Number | 1912545930
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Entity Type | Organization
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Legal Business Name | SERENITY RIDGE PALLIATIVE AND HOSPICE CARE
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Dates
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Enumeration Date | 12/20/2019
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Last Update Date | 12/20/2019
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Provider Practice Location Address
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Address Line | 11239 TAMPA AVE STE 203
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City | PORTER RANCH
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State | CA
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Zip | 91326-3784
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Country | US
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Telephone | 818-217-4436
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Fax | 818-217-4336
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Provider Business Mailing Address
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Address Line | 11239 TAMPA AVE STE 203
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City | PORTER RANCH
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State | CA
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Zip | 91326-3784
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Country | US
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Telephone | 818-217-4436
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Fax | 818-217-4336
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Authorized Official
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Title or Position | CEO/CFO/SECRETARY
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Name | MR. AVO KRIKOR HARUTUNIAN
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Credential |
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Telephone | 818-217-4436
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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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