=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982206249
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TARZANA HOSPICE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/12/2020
-----------------------------------------------------
Last Update Date | 11/12/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6047 TAMPA AVE STE 205
-----------------------------------------------------
City | TARZANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91356-1183
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-913-9363
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6047 TAMPA AVE STE 205
-----------------------------------------------------
City | TARZANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91356-1183
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-913-9363
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. ARMEN APOYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 800-913-9363
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------