Healthcare Provider Details

I. General information

NPI: 1407609506
Provider Name (Legal Business Name): MADISSON HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8921 DE SOTO AVE STE 203
CANOGA PARK CA
91304-1910
US

IV. Provider business mailing address

8921 DE SOTO AVE STE 203
CANOGA PARK CA
91304-1910
US

V. Phone/Fax

Practice location:
  • Phone: 833-364-1383
  • Fax: 818-561-4498
Mailing address:
  • Phone: 833-364-1383
  • Fax: 818-561-4498

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: GEVORG MINASYAN
Title or Position: CEO
Credential:
Phone: 833-364-1383