Provider Demographics
NPI:1699106120
Name:LUCKY PALLIATIVE SERVICES, INCORPORATED
Entity type:Organization
Organization Name:LUCKY PALLIATIVE SERVICES, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARAMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-207-9954
Mailing Address - Street 1:20944 SHERMAN WAY ST.
Mailing Address - Street 2:UNIT 204
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303
Mailing Address - Country:US
Mailing Address - Phone:818-207-9954
Mailing Address - Fax:
Practice Address - Street 1:20944 SHERMAN WAY ST.
Practice Address - Street 2:UNIT 204
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303
Practice Address - Country:US
Practice Address - Phone:818-207-9954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based