MEDICARE: COUNTRY CLUB HOSPICE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1215543434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTRY CLUB HOSPICE, INC.

Provider Business Mailing Address
First Line	:	3089 N LIMA ST STE D
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-2013
Country	:	US
Telephone Number	:	747-200-4175
Fax Number	:	747-273-0558

Provider Business Practice Location Address
First Line	:	3089 N LIMA ST STE D
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-2013
Country	:	US
Telephone Number	:	747-200-4175
Fax Number	:	747-273-0558

Authorized Official
Title or Position	:	CEO
Name	:	MR. DAVID GABRIELYAN
Credential	:
Telephone Number	:	747-200-4175

Provider Enumeration Date	:	09/22/2020
Last Update Date	:	02/04/2021

Similar Medicare Providers

1851907083 — ALWAYS ATTENTIVE HOME HEALTH CARE
Practice Location Address:

3099 N LIMA ST UNIT A
BURBANK, CA
91504-2013

Practice Phone: 818-281-7946
Practice Fax:

1932599982 — ARGO HOSPICE, INC.
Practice Location Address:

3089 N LIMA ST STE 105
BURBANK, CA
91504-2013

Practice Phone: 818-422-0221
Practice Fax: 818-301-5028

1770048738 — GOLDEN SEASONS HOSPICE, INC.
Practice Location Address:

3089 N LIMA ST STE A
BURBANK, CA
91504-2013

Practice Phone: 818-538-5863
Practice Fax: 818-538-5882

1831715077 — BLOOMING ROSE HOSPICE, INC.
Practice Location Address:

3089 N LIMA ST # C
BURBANK, CA
91504-2013

Practice Phone: 818-208-3066
Practice Fax: 818-226-3246

1922606508 — HOME HEALTH CALA
Practice Location Address:

3099 N LIMA ST UNIT B
BURBANK, CA
91504-2013

Practice Phone: 213-952-2992
Practice Fax:

1144895715 — ROYAL HERITAGE HOSPICE, INC.
Practice Location Address:

3089 N LIMA ST # B
BURBANK, CA
91504-2013

Practice Phone: 800-756-0603
Practice Fax: 800-756-3305

Directions to “COUNTRY CLUB HOSPICE, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.