Healthcare Provider Details

I. General information

NPI: 1891372272
Provider Name (Legal Business Name): LIVING TREE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 LAUREL CANYON BLVD STE 226
VALLEY VILLAGE CA
91607-2788
US

IV. Provider business mailing address

5301 LAUREL CANYON BLVD STE 226
VALLEY VILLAGE CA
91607-2788
US

V. Phone/Fax

Practice location:
  • Phone: 805-728-5365
  • Fax: 805-830-1196
Mailing address:
  • Phone: 805-728-5365
  • Fax: 805-830-1196

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: LUSINE GEVORGYAN
Title or Position: CEO
Credential:
Phone: 805-728-5365