MEDICARE: INFINITE CARE 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	:	1285159483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITE CARE HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	12011 VICTORY BLVD STE 101
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-3330
Country	:	US
Telephone Number	:	747-257-6501
Fax Number	:	818-301-2006

Provider Business Practice Location Address
First Line	:	12011 VICTORY BLVD STE 101
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-3330
Country	:	US
Telephone Number	:	747-257-6501
Fax Number	:	818-301-2006

Authorized Official
Title or Position	:	CEO
Name	:	MANUK PARSAMYAN
Credential	:
Telephone Number	:	747-257-6501

Provider Enumeration Date	:	08/08/2017
Last Update Date	:	07/21/2022

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