Provider Demographics
NPI:1699158907
Name:SVA HOSPICE
Entity type:Organization
Organization Name:SVA HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARUTYUNYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-946-8061
Mailing Address - Street 1:13758 VICTORY BLVD
Mailing Address - Street 2:SUITE #209
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-2359
Mailing Address - Country:US
Mailing Address - Phone:818-946-8061
Mailing Address - Fax:818-946-8062
Practice Address - Street 1:13758 VICTORY BLVD
Practice Address - Street 2:SUITE #209
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-2359
Practice Address - Country:US
Practice Address - Phone:818-946-8061
Practice Address - Fax:818-946-8062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-06
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
3788119OtherCORPORATE NUMBER