MEDICARE: HEARTFUL HOSPICE CARE, 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	:	1255920773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTFUL HOSPICE CARE, INC.

Provider Business Mailing Address
First Line	:	2500 E FOOTHILL BLVD STE 206
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-3460
Country	:	US
Telephone Number	:	818-795-9269
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 E FOOTHILL BLVD STE 206
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-3460
Country	:	US
Telephone Number	:	818-795-9269
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SUREN SAHAKYAN
Credential	:
Telephone Number	:	818-795-9269

Provider Enumeration Date	:	01/11/2021
Last Update Date	:	01/11/2021

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