Healthcare Provider Details

I. General information

NPI: 1104458744
Provider Name (Legal Business Name): INBETHA HOME HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14545 FRIAR ST STE 174
VAN NUYS CA
91411-2397
US

IV. Provider business mailing address

14545 FRIAR ST STE 174
VAN NUYS CA
91411-2397
US

V. Phone/Fax

Practice location:
  • Phone: 818-795-2953
  • Fax:
Mailing address:
  • Phone:
  • 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: ANNA ADAMYAN
Title or Position: CEO
Credential:
Phone: 805-971-9177