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General NPI Number Information
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NPI Number | 1003066275
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Entity Type | Organization
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Legal Business Name | RADUGA HOME HEALTH AGENCY
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | 635 W COLORADO ST SUITE 104
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City | GLENDALE
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State | CA
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Zip | 91204-1175
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Country | US
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Telephone | 818-455-9722
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Fax | 818-500-0223
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Provider Business Mailing Address
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Address Line | 1317 ALAMEDA AVE
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City | GLENDALE
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State | CA
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Zip | 91201-1119
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Country | US
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Telephone | 818-455-9722
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Fax | 818-500-0223
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NONA OGANISYAN
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Credential |
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Telephone | 818-455-9722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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