Healthcare Provider Details

I. General information

NPI: 1184204026
Provider Name (Legal Business Name): HEALTHY MIND HOME CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E BROADWAY STE 205C
GLENDALE CA
91205-1008
US

IV. Provider business mailing address

225 E BROADWAY STE 205C
GLENDALE CA
91205-1008
US

V. Phone/Fax

Practice location:
  • Phone: 818-405-3410
  • Fax: 818-484-3708
Mailing address:
  • Phone: 818-405-3410
  • Fax: 818-484-3708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: HAYK ZOHRABYAN
Title or Position: CEO
Credential:
Phone: 818-405-3410