MEDICARE: PROFESSIONAL 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	550000822	CA

General Provider Information

NPI Number	:	1952506032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	415 E HARVARD ST
Second Line	:	SUITE 205
City	:	GLENDALE
State	:	CA
Zip	:	91205-1057
Country	:	US
Telephone Number	:	818-507-1125
Fax Number	:	818-507-0993

Provider Business Practice Location Address
First Line	:	415 E HARVARD ST
Second Line	:	SUITE 205
City	:	GLENDALE
State	:	CA
Zip	:	91205-1057
Country	:	US
Telephone Number	:	818-507-1125
Fax Number	:	818-507-0993

Authorized Official
Title or Position	:	CEO
Name	:	HRAIR AREDJIAN
Credential	:
Telephone Number	:	818-507-1125

Provider Enumeration Date	:	06/18/2007
Last Update Date	:	02/08/2018

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