Healthcare Provider Details

I. General information

NPI: 1356097190
Provider Name (Legal Business Name): NMD HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12444 VICTORY BLVD STE 301-N2
NORTH HOLLYWOOD CA
91606
US

IV. Provider business mailing address

12444 VICTORY BLVD STE 301-N2
NORTH HOLLYWOOD CA
91606
US

V. Phone/Fax

Practice location:
  • Phone: 747-721-4393
  • Fax: 747-877-9309
Mailing address:
  • Phone: 747-721-4393
  • Fax: 747-877-9309

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: ANAHIT YESAYAN
Title or Position: CEO,CFO,SECRETARY
Credential:
Phone: 747-271-4393