Healthcare Provider Details

I. General information

NPI: 1780035121
Provider Name (Legal Business Name): JADE HEALTH VENTURES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 06/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 N BRIGHTON ST
BURBANK CA
91506-1202
US

IV. Provider business mailing address

1226 N BRIGHTON ST
BURBANK CA
91506-1202
US

V. Phone/Fax

Practice location:
  • Phone: 213-400-0022
  • Fax: 323-663-8455
Mailing address:
  • Phone: 213-400-0022
  • Fax: 323-663-8455

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: GEVORK YARALYAN
Title or Position: CEO
Credential:
Phone: 213-400-0022