Healthcare Provider Details

I. General information

NPI: 1861017881
Provider Name (Legal Business Name): LA HOME HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 E COLORADO ST STE 200
GLENDALE CA
91205-4548
US

IV. Provider business mailing address

1012 E COLORADO ST STE 200
GLENDALE CA
91205-4548
US

V. Phone/Fax

Practice location:
  • Phone: 818-484-7780
  • Fax: 818-484-7786
Mailing address:
  • Phone: 818-484-7780
  • Fax: 818-484-7786

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: KHACHATUR HARUTUNIAN
Title or Position: CEO
Credential:
Phone: 818-484-7780