Healthcare Provider Details

I. General information

NPI: 1982374773
Provider Name (Legal Business Name): WHOLE HEART HOME HEALTH AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 W LEXINGTON DR STE 206D
GLENDALE CA
91203-3136
US

IV. Provider business mailing address

121 W LEXINGTON DR STE 206D
GLENDALE CA
91203-3136
US

V. Phone/Fax

Practice location:
  • Phone: 323-553-0836
  • Fax:
Mailing address:
  • Phone: 323-553-0836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. ERIC YEPISKOPOSYAN
Title or Position: CEO
Credential: BSN, RN
Phone: 323-553-0836