MEDICARE: INSPIRED LIFE HOME HEALTH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1093163842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSPIRED LIFE HOME HEALTH INC

Provider Business Mailing Address
First Line	:	10746 BURBANK BLVD STE D
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2528
Country	:	US
Telephone Number	:	909-361-4410
Fax Number	:	909-361-4440

Provider Business Practice Location Address
First Line	:	10746 BURBANK BLVD STE D
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2528
Country	:	US
Telephone Number	:	909-361-4410
Fax Number	:	909-361-4440

Authorized Official
Title or Position	:	CEO
Name	:	NAKSHUN PETROSYAN
Credential	:
Telephone Number	:	909-361-4410

Provider Enumeration Date	:	06/01/2016
Last Update Date	:	12/27/2023

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