Healthcare Provider Details

I. General information

NPI: 1295472314
Provider Name (Legal Business Name): AT-HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28924 S WESTERN AVE STE 100F
RANCHO PALOS VERDES CA
90275-0885
US

IV. Provider business mailing address

28924 S WESTERN AVE STE 100F
RANCHO PALOS VERDES CA
90275-0885
US

V. Phone/Fax

Practice location:
  • Phone: 310-757-2037
  • Fax: 310-742-0474
Mailing address:
  • Phone: 310-757-2037
  • Fax: 310-742-0474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ARMINE ANTONYAN
Title or Position: CEO
Credential:
Phone: 424-362-6891