Healthcare Provider Details

I. General information

NPI: 1437646460
Provider Name (Legal Business Name): HUNTINGTON HOME HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 04/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 N ALTADENA DR UNIT 255
PASADENA CA
91107-7352
US

IV. Provider business mailing address

1296 N ALLEN AVE
PASADENA CA
91104-3212
US

V. Phone/Fax

Practice location:
  • Phone: 626-365-1423
  • 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
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ARKADI VARDANYAN
Title or Position: PRESIDENT
Credential:
Phone: 626-365-1423