MEDICARE: CLEAR SKY 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	:	1922678846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAR SKY HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	1915 W GLENOAKS BLVD STE 201A
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-1541
Country	:	US
Telephone Number	:	818-538-7418
Fax Number	:	818-538-7419

Provider Business Practice Location Address
First Line	:	1915 W GLENOAKS BLVD STE 201A
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-1541
Country	:	US
Telephone Number	:	818-538-7418
Fax Number	:	818-538-7419

Authorized Official
Title or Position	:	CEO
Name	:	AMALIA KARAPETYAN
Credential	:
Telephone Number	:	818-538-7418

Provider Enumeration Date	:	07/01/2021
Last Update Date	:	07/01/2021

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