Healthcare Provider Details

I. General information

NPI: 1417608449
Provider Name (Legal Business Name): IDYLLIC HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2022
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 W BURBANK BLVD STE 101
BURBANK CA
91506-1234
US

IV. Provider business mailing address

2220 W BURBANK BLVD STE 101
BURBANK CA
91506-1234
US

V. Phone/Fax

Practice location:
  • Phone: 800-570-9863
  • Fax:
Mailing address:
  • Phone: 800-570-9863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DIANA AKHVERDYAN
Title or Position: CEO
Credential:
Phone: 800-570-9863