Provider Demographics
NPI:1154708691
Name:MAGNOLIA GARDENS HOSPICE, INC.
Entity type:Organization
Organization Name:MAGNOLIA GARDENS HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANAID
Authorized Official - Middle Name:
Authorized Official - Last Name:BEKJANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-217-1101
Mailing Address - Street 1:10523 BURBANK BLVD
Mailing Address - Street 2:#215
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-2233
Mailing Address - Country:US
Mailing Address - Phone:818-217-1101
Mailing Address - Fax:818-217-1170
Practice Address - Street 1:10523 BURBANK BLVD
Practice Address - Street 2:#215
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-2233
Practice Address - Country:US
Practice Address - Phone:818-217-1101
Practice Address - Fax:818-217-1170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based