Healthcare Provider Details

I. General information

NPI: 1982541058
Provider Name (Legal Business Name): BLOOMING CARE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 LAUREL CANYON BLVD STE 201
VALLEY VILLAGE CA
91607-4966
US

IV. Provider business mailing address

5301 LAUREL CANYON BLVD STE 201
VALLEY VILLAGE CA
91607-4966
US

V. Phone/Fax

Practice location:
  • Phone: 424-493-7209
  • Fax: 424-316-3003
Mailing address:
  • Phone: 424-493-7209
  • Fax: 424-316-3003

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: SONA GRIGORYAN
Title or Position: CEO
Credential:
Phone: 424-493-7209