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General NPI Number Information
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NPI Number | 1093414435
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Entity Type | Organization
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Legal Business Name | OPTION ONE HOME HEALTH CARE, INC
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 16218 MIL POTRERO HWY UNIT 201 STE A
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City | PINE MOUNTAIN CLUB
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State | CA
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Zip | 93222
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Country | US
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Telephone | 818-697-4481
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Fax | 818-294-7119
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Provider Business Mailing Address
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Address Line | PO BOX 6841
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City | PINE MOUNTAIN CLUB
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State | CA
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Zip | 93222-6841
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Country | US
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Telephone | 818-697-4481
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Fax |
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Authorized Official
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Title or Position | CEO,CFO,OWNER,SECRETARY
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Name | LEVON VARDAPETYAN
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Credential |
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Telephone | 818-697-4481
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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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