Healthcare Provider Details

I. General information

NPI: 1023684784
Provider Name (Legal Business Name): HOLY HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3504 W MAGNOLIA BLVD STE 210
BURBANK CA
91505-2911
US

IV. Provider business mailing address

3504 W MAGNOLIA BLVD STE 210
BURBANK CA
91505-2911
US

V. Phone/Fax

Practice location:
  • Phone: 747-295-1588
  • Fax: 818-301-2038
Mailing address:
  • Phone: 747-295-1588
  • Fax: 818-301-2038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ARSHAK GASPARYAN
Title or Position: CEO
Credential:
Phone: 747-295-1588