Healthcare Provider Details

I. General information

NPI: 1255874152
Provider Name (Legal Business Name): NOURISH HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2016
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14545 FRIAR ST 208
VAN NUYS CA
91411-2397
US

IV. Provider business mailing address

14545 FRIAR ST 208
VAN NUYS CA
91411-2397
US

V. Phone/Fax

Practice location:
  • Phone: 818-692-2509
  • 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: EVA BIYAZYAN
Title or Position: CEO
Credential: CEO
Phone: 818-692-2509