Healthcare Provider Details

I. General information

NPI: 1861358897
Provider Name (Legal Business Name): HESTIA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2026
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 NORTON AVE
GLENDALE CA
91202-2029
US

IV. Provider business mailing address

4520 ROSEMONT AVE APT 302
LA CRESCENTA CA
91214-3169
US

V. Phone/Fax

Practice location:
  • Phone: 818-669-0248
  • Fax:
Mailing address:
  • Phone: 818-669-0248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RYAN CHUNG
Title or Position: COO
Credential:
Phone: 818-669-0248