Healthcare Provider Details

I. General information

NPI: 1831817691
Provider Name (Legal Business Name): NEW GENERATION HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2022
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12445 MOORPARK ST STE B
STUDIO CITY CA
91604-1270
US

IV. Provider business mailing address

12445 MOORPARK ST STE B
STUDIO CITY CA
91604-1270
US

V. Phone/Fax

Practice location:
  • Phone: 870-888-8844
  • Fax: 818-732-8520
Mailing address:
  • Phone: 870-888-8844
  • Fax: 818-732-8520

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: LILIT SIMONYAN
Title or Position: CEO
Credential:
Phone: 870-888-8844