Healthcare Provider Details

I. General information

NPI: 1164188629
Provider Name (Legal Business Name): VENERA HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322A E BROADWAY
GLENDALE CA
91205-1011
US

IV. Provider business mailing address

322A E BROADWAY
GLENDALE CA
91205-1011
US

V. Phone/Fax

Practice location:
  • Phone: 424-362-3636
  • Fax: 818-572-8717
Mailing address:
  • Phone: 747-609-6538
  • Fax: 818-572-8717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: SONA ALEKSANYAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 424-362-3636