Healthcare Provider Details
I. General information
NPI: 1346794872
Provider Name (Legal Business Name): WISH U WELL HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2016
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6501 FOOTHILL BLVD # A202
TUJUNGA CA
91042-2765
US
IV. Provider business mailing address
6501 FOOTHILL BLVD # A202
TUJUNGA CA
91042-2765
US
V. Phone/Fax
- Phone: 818-293-3012
- Fax: 818-760-7359
- Phone: 818-293-3012
- Fax: 818-760-7359
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
HOVHANNES
VARDANYAN
Title or Position: CEO
Credential:
Phone: 818-293-3012