Provider Demographics
NPI:1356972061
Name:LA HOSPICE GROUP INC
Entity type:Organization
Organization Name:LA HOSPICE GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEVORKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-495-0889
Mailing Address - Street 1:232 N LAKE AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1862
Mailing Address - Country:US
Mailing Address - Phone:626-495-0889
Mailing Address - Fax:
Practice Address - Street 1:232 N LAKE AVE STE 214
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1862
Practice Address - Country:US
Practice Address - Phone:626-495-0889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-31
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based