Provider Demographics
NPI:1871140996
Name:LIBERTY HOSPICE CARE
Entity type:Organization
Organization Name:LIBERTY HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KALAJYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-272-9887
Mailing Address - Street 1:14407 GILMORE ST STE 202B
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-1400
Mailing Address - Country:US
Mailing Address - Phone:747-272-9887
Mailing Address - Fax:818-475-1788
Practice Address - Street 1:14407 GILMORE ST STE 202B
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1400
Practice Address - Country:US
Practice Address - Phone:747-272-9887
Practice Address - Fax:818-475-1788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-22
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based