Healthcare Provider Details

I. General information

NPI: 1619804846
Provider Name (Legal Business Name): MHA HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 W LEXINGTON DR STE 517B
GLENDALE CA
91203-3665
US

IV. Provider business mailing address

121 W LEXINGTON DR STE 517B
GLENDALE CA
91203-3665
US

V. Phone/Fax

Practice location:
  • Phone: 747-330-4994
  • Fax: 747-400-1580
Mailing address:
  • Phone: 747-330-4994
  • Fax: 747-400-1580

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: GAGIK MANUKYAN
Title or Position: CEO
Credential:
Phone: 747-330-4994