MEDICARE: MOTHER THERESA'S HOME HEALTH CARE SERVICES 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	:	1497776058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOTHER THERESA'S HOME HEALTH CARE SERVICES INC.

Provider Business Mailing Address
First Line	:	847 N HOLLYWOOD WAY
Second Line	:	#203
City	:	BURBANK
State	:	CA
Zip	:	91505-2843
Country	:	US
Telephone Number	:	818-505-9099
Fax Number	:	818-505-9554

Provider Business Practice Location Address
First Line	:	847 N HOLLYWOOD WAY
Second Line	:	#203
City	:	BURBANK
State	:	CA
Zip	:	91505-2843
Country	:	US
Telephone Number	:	818-505-9099
Fax Number	:	818-505-9554

Authorized Official
Title or Position	:	ADMINISTRATOR PRESIDENT
Name	:	KRISTINA KASABYAN
Credential	:
Telephone Number	:	818-505-9099

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	09/05/2017

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