Healthcare Provider Details

I. General information

NPI: 1982250106
Provider Name (Legal Business Name): NOVA VITA HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 08/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 S GLENDALE AVE STE 202C
GLENDALE CA
91205-3388
US

IV. Provider business mailing address

1241 S GLENDALE AVE STE 202C
GLENDALE CA
91205-3388
US

V. Phone/Fax

Practice location:
  • Phone: 818-291-3220
  • Fax: 818-671-2773
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: RUZANNA PAHLAVUNI
Title or Position: CEO
Credential:
Phone: 818-291-3220