MEDICARE: SAINT MARIA 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	:	1912451592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT MARIA HOSPICE CARE INC.

Provider Business Mailing Address
First Line	:	5503 CAHUENGA BLVD STE 200
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2920
Country	:	US
Telephone Number	:	818-648-1767
Fax Number	:	818-242-1248

Provider Business Practice Location Address
First Line	:	5503 CAHUENGA BLVD STE 200
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2920
Country	:	US
Telephone Number	:	818-648-1767
Fax Number	:	818-242-1248

Authorized Official
Title or Position	:	CEO
Name	:	MARO SAFRAZBEKYAN
Credential	:
Telephone Number	:	818-648-1767

Provider Enumeration Date	:	08/11/2016
Last Update Date	:	02/14/2017

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