MEDICARE: AVANTI 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	:	1598234106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVANTI HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	7127 LAUREL CANYON BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-5741
Country	:	US
Telephone Number	:	888-407-4047
Fax Number	:	818-737-4222

Provider Business Practice Location Address
First Line	:	7127 LAUREL CANYON BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-5741
Country	:	US
Telephone Number	:	888-407-4047
Fax Number	:	818-737-4222

Authorized Official
Title or Position	:	CEO
Name	:	ANDRANIK AZATYAN
Credential	:
Telephone Number	:	888-407-4047

Provider Enumeration Date	:	11/13/2018
Last Update Date	:	11/13/2018

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