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General NPI Number Information
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NPI Number | 1104401926
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Entity Type | Organization
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Legal Business Name | IMPETUS HOME HEALTH CARE
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Dates
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Enumeration Date | 03/12/2021
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Last Update Date | 03/12/2021
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Provider Practice Location Address
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Address Line | 133 N ALTADENA DR STE 309
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City | PASADENA
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State | CA
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Zip | 91107-7341
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Country | US
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Telephone | 626-399-5716
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Fax |
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Provider Business Mailing Address
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Address Line | 133 N ALTADENA DR STE 309
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City | PASADENA
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State | CA
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Zip | 91107-7341
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Country | US
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Telephone | 626-399-5716
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO, SECRETARY
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Name | KARINE NAGAPETIAN
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Credential |
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Telephone | 626-314-3699
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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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