Healthcare Provider Details

I. General information

NPI: 1497477863
Provider Name (Legal Business Name): NIGHTINGALE S HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7324 SEPULVEDA BLVD STE E
VAN NUYS CA
91405-5033
US

IV. Provider business mailing address

7324 SEPULVEDA BLVD STE E
VAN NUYS CA
91405-5033
US

V. Phone/Fax

Practice location:
  • Phone: 818-861-4708
  • Fax:
Mailing address:
  • Phone: 818-861-4708
  • 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: HRACHYA GREG GRIGORYAN
Title or Position: CEO
Credential:
Phone: 818-861-4708