Provider Demographics
NPI:1417225160
Name:FATE HOSPICE CARE, INC.
Entity type:Organization
Organization Name:FATE HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEVORK
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:YARALYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-775-0525
Mailing Address - Street 1:20945 DEVONSHIRE ST
Mailing Address - Street 2:STE 101B
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2394
Mailing Address - Country:US
Mailing Address - Phone:818-775-0525
Mailing Address - Fax:818-775-0535
Practice Address - Street 1:20945 DEVONSHIRE ST
Practice Address - Street 2:STE 101B
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2394
Practice Address - Country:US
Practice Address - Phone:818-775-0525
Practice Address - Fax:818-775-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based