Magnolia Park Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

MAGNOLIA PARK HOSPICE, INC.

Practice address

4741 Laurel Canyon Blvd
Suite 201
Valley Village, CA 91607-3934

Phone

(818) 985-6800

Fax

(818) 985-6808

NPI assigned

May 23, 2016

Organization subpart

No

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

Authorized official

Name

Dmitriy Brodskiy

Title

Ceo

Phone

(818) 985-6800

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463961600000",
    "number": "1821445461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4741 LAUREL CANYON BLVD",
            "address_2": "SUITE 201",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073934",
            "telephone_number": "818-985-6800",
            "fax_number": "818-985-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 LAUREL CANYON BLVD",
            "address_2": "SUITE 201",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073934",
            "telephone_number": "818-985-6800",
            "fax_number": "818-985-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PARK HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-23",
        "last_updated": "2016-05-23",
        "status": "A",
        "authorized_official_last_name": "BRODSKIY",
        "authorized_official_first_name": "DMITRIY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-985-6800"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Magnolia Recovery, LLC.
• Alexandra Malone
• Frederic Carl Mandell, DDS
• Jennifer Manley-Stanley
• Elizabeth Maramot-Stallings

• Community Based Hospice Care Agency in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; 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.