Healthcare Provider Details

I. General information

NPI: 1881242378
Provider Name (Legal Business Name): LA VIDA HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 E OLIVE AVE STE G
BURBANK CA
91502-1250
US

IV. Provider business mailing address

348 E OLIVE AVE STE G
BURBANK CA
91502-1250
US

V. Phone/Fax

Practice location:
  • Phone: 818-860-4101
  • Fax: 818-860-4105
Mailing address:
  • Phone: 818-860-4101
  • Fax: 818-860-4105

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: SUSANNA GRIGORYAN
Title or Position: CEO
Credential:
Phone: 818-860-4101