Healthcare Provider Details

I. General information

NPI: 1700494762
Provider Name (Legal Business Name): AUTHORIZED HOME HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S GLENOAKS BLVD STE 203
BURBANK CA
91502-2707
US

IV. Provider business mailing address

12410 BURBANK BLVD STE 200
VALLEY VILLAGE CA
91607-4732
US

V. Phone/Fax

Practice location:
  • Phone: 818-821-3006
  • Fax: 818-821-3024
Mailing address:
  • Phone: 818-821-3006
  • Fax: 818-821-3024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. AUGUSTA ROSETTA BOHANNON
Title or Position: BUSINESS CONSULTANT
Credential: RN
Phone: 818-821-5184