Healthcare Provider Details

I. General information

NPI: 1902480114
Provider Name (Legal Business Name): SORA HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 N LARK ELLEN AVE STE G
WEST COVINA CA
91791-1099
US

IV. Provider business mailing address

855 N LARK ELLEN AVE STE G
WEST COVINA CA
91791-1099
US

V. Phone/Fax

Practice location:
  • Phone: 626-479-1480
  • Fax:
Mailing address:
  • Phone: 626-479-1480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: HERMINE KESHISHYAN
Title or Position: CEO
Credential:
Phone: 626-479-1480