Providence Hospice Services, Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PROVIDENCE HOSPICE SERVICES, INC

Practice address

4854 Van Nuys Blvd Ste 220
Sherman Oaks, CA 91403-2166

Phone

(818) 395-8385

Fax

(818) 395-8385

NPI assigned

May 26, 2021

Last updated

May 26, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Hambartsum Mkrtchian

Title

Ceo

Phone

(818) 395-8385

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621987200000",
    "number": "1588239941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4854 VAN NUYS BLVD STE 220",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032166",
            "telephone_number": "818-395-8385",
            "fax_number": "818-395-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4854 VAN NUYS BLVD STE 220",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032166",
            "telephone_number": "818-395-8385",
            "fax_number": "818-395-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HOSPICE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A",
        "authorized_official_last_name": "MKRTCHIAN",
        "authorized_official_first_name": "HAMBARTSUM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-395-8385"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.