MEDICARE: BERKSHIRE HOME HEALTH CARE 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	:	1144961814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERKSHIRE HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	12626 RIVERSIDE DR STE 301
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-3473
Country	:	US
Telephone Number	:	508-681-2778
Fax Number	:

Provider Business Practice Location Address
First Line	:	12626 RIVERSIDE DR STE 301
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-3473
Country	:	US
Telephone Number	:	508-681-2778
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LILIT VARDANYAN
Credential	:
Telephone Number	:	508-681-2778

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	04/05/2022

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