MEDICARE: SAINT MANUEL 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	:	1861702326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT MANUEL HOSPICE, INC.

Provider Business Mailing Address
First Line	:	6005 VINELAND AVE
Second Line	:	SUITE 202
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-4981
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6005 VINELAND AVE STE 202
Second Line	:
City	:	N HOLLYWOOD
State	:	CA
Zip	:	91606-4984
Country	:	US
Telephone Number	:	818-484-6475
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MONIK MANUKIAN
Credential	:
Telephone Number	:	818-484-6475

Provider Enumeration Date	:	10/19/2010
Last Update Date	:	02/04/2016

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