Healthcare Provider Details

I. General information

NPI: 1831813500
Provider Name (Legal Business Name): MNATSAKANYANS HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2022
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 ARDEN AVE STE 105
GLENDALE CA
91203-1110
US

IV. Provider business mailing address

350 ARDEN AVE STE 105
GLENDALE CA
91203-1110
US

V. Phone/Fax

Practice location:
  • Phone: 818-747-7799
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: IDA MNATZAGANIAN
Title or Position: PRESIDENT /CEO
Credential:
Phone: 818-747-7799