Healthcare Provider Details
I. General information
NPI: 1659028819
Provider Name (Legal Business Name): TITAN HOME HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/08/2022
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6320 VAN NUYS BLVD STE 205
VAN NUYS CA
91401-6634
US
IV. Provider business mailing address
6320 VAN NUYS BLVD STE 205
VAN NUYS CA
91401-6634
US
V. Phone/Fax
- Phone: 747-222-3993
- Fax: 818-484-3903
- Phone: 747-222-3993
- Fax: 818-484-3903
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YANA
ROSTOMYAN
Title or Position: CEO
Credential:
Phone: 747-222-3993