Provider Demographics
NPI:1144828500
Name:IE COMMUNITY HOSPICE, INC.
Entity type:Organization
Organization Name:IE COMMUNITY HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAROUTYOUN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOURINIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-604-5775
Mailing Address - Street 1:600 N MOUNTAIN AVE STE B102
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4359
Mailing Address - Country:US
Mailing Address - Phone:909-321-2255
Mailing Address - Fax:909-351-0151
Practice Address - Street 1:600 N MOUNTAIN AVE STE B102
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4359
Practice Address - Country:US
Practice Address - Phone:909-321-2255
Practice Address - Fax:909-351-0151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based