Provider Demographics
NPI:1295290138
Name:GRAVATIS HOSPICE CARE INC
Entity type:Organization
Organization Name:GRAVATIS HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MADLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALASHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-254-3837
Mailing Address - Street 1:263 W OLIVE AVE STE 153
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1825
Mailing Address - Country:US
Mailing Address - Phone:747-254-3837
Mailing Address - Fax:747-202-1016
Practice Address - Street 1:427 S VICTORY BLVD STE C
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-2353
Practice Address - Country:US
Practice Address - Phone:747-254-3837
Practice Address - Fax:747-202-1016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based