Provider Demographics
NPI:1124638366
Name:LIFE RENEWAL HOSPICE CARE INC.
Entity type:Organization
Organization Name:LIFE RENEWAL HOSPICE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHAKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-909-5655
Mailing Address - Street 1:16442 VANOWEN ST STE C
Mailing Address - Street 2:
Mailing Address - City:LAKE BALBOA
Mailing Address - State:CA
Mailing Address - Zip Code:91406-4729
Mailing Address - Country:US
Mailing Address - Phone:323-909-5655
Mailing Address - Fax:
Practice Address - Street 1:16442 VANOWEN ST STE C
Practice Address - Street 2:
Practice Address - City:LAKE BALBOA
Practice Address - State:CA
Practice Address - Zip Code:91406-4729
Practice Address - Country:US
Practice Address - Phone:323-909-5655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based