Provider Demographics
NPI:1417562778
Name:FATE HOSPICE INC
Entity type:Organization
Organization Name:FATE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTARAM
Authorized Official - Middle Name:ANNA
Authorized Official - Last Name:KUSHKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-631-6101
Mailing Address - Street 1:1461 E CHEVY CHASE DR STE 100A
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4090
Mailing Address - Country:US
Mailing Address - Phone:626-631-6101
Mailing Address - Fax:
Practice Address - Street 1:1461 E CHEVY CHASE DR STE 100A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4090
Practice Address - Country:US
Practice Address - Phone:626-631-6101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based