Provider Demographics
NPI:1720693971
Name:PRISTINE CARE HOSPICE CORP.
Entity type:Organization
Organization Name:PRISTINE CARE HOSPICE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRAKOSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-477-6757
Mailing Address - Street 1:7311 VAN NUYS BLVD
Mailing Address - Street 2:UNIT 12
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-1958
Mailing Address - Country:US
Mailing Address - Phone:747-205-1841
Mailing Address - Fax:818-241-5859
Practice Address - Street 1:7311 VAN NUYS BLVD
Practice Address - Street 2:UNIT 12
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-1958
Practice Address - Country:US
Practice Address - Phone:747-205-1841
Practice Address - Fax:818-241-5859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based