Healthcare Provider Details

I. General information

NPI: 1710696430
Provider Name (Legal Business Name): EMINENCE HOME HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E BROADWAY STE 109B
GLENDALE CA
91205-1008
US

IV. Provider business mailing address

225 E BROADWAY STE 109B
GLENDALE CA
91205-1008
US

V. Phone/Fax

Practice location:
  • Phone: 818-536-7347
  • Fax: 818-536-7473
Mailing address:
  • Phone: 818-536-7347
  • Fax: 818-536-7473

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: MRS. LUSINE ALIKHANIAN
Title or Position: CEO
Credential:
Phone: 818-536-7347