Healthcare Provider Details

I. General information

NPI: 1295378024
Provider Name (Legal Business Name): SOCIAL HOME HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13083 VAN NUYS BLVD STE 2
PACOIMA CA
91331-2575
US

IV. Provider business mailing address

13083 VAN NUYS BLVD STE 2
PACOIMA CA
91331-2575
US

V. Phone/Fax

Practice location:
  • Phone: 818-650-1155
  • Fax:
Mailing address:
  • Phone: 818-650-1155
  • 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: ADRINE ASTVATSATRYAN
Title or Position: CEO
Credential:
Phone: 818-650-1155