Healthcare Provider Details

I. General information

NPI: 1174001978
Provider Name (Legal Business Name): LIFELONG HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10019 COMMERCE AVE
TUJUNGA CA
91042-2303
US

IV. Provider business mailing address

10019 COMMERCE AVE
TUJUNGA CA
91042-2303
US

V. Phone/Fax

Practice location:
  • Phone: 818-653-8642
  • Fax:
Mailing address:
  • Phone: 818-653-8642
  • 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: ANI ASLANYAN
Title or Position: CEO
Credential:
Phone: 818-653-8642