MEDICARE: GREEN PARADISE 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	:	1831721893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREEN PARADISE HOSPICE CARE, INC

Provider Business Mailing Address
First Line	:	5658 SEPULVEDA BLVD STE 201
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91411-2951
Country	:	US
Telephone Number	:	818-290-3602
Fax Number	:

Provider Business Practice Location Address
First Line	:	5658 SEPULVEDA BLVD STE 201
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91411-2951
Country	:	US
Telephone Number	:	818-290-3602
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KARAPET AKHVERDYAN
Credential	:
Telephone Number	:	818-290-3602

Provider Enumeration Date	:	02/07/2020
Last Update Date	:	08/09/2023

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