Healthcare Provider Details

I. General information

NPI: 1265071393
Provider Name (Legal Business Name): HEPIUS HOME HEALTH CARE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2020
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2652 HONOLULU AVE # 1/2
MONTROSE CA
91020-1763
US

IV. Provider business mailing address

2652 HONOLULU AVE # 1/2
MONTROSE CA
91020-1763
US

V. Phone/Fax

Practice location:
  • Phone: 818-302-0816
  • 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: MAYA CHAKHALYAN
Title or Position: CEO
Credential:
Phone: 818-302-0816