=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174854772
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAITH & HOPE HOME HEALTH INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2010
-----------------------------------------------------
Last Update Date | 02/11/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 144 S FIRST ST NUM 200A
-----------------------------------------------------
City | BURBANK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91502-1948
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-333-0880
-----------------------------------------------------
Fax | 818-333-1563
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 144 S FIRST ST NUM 200A
-----------------------------------------------------
City | BURBANK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91502-1948
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-333-0880
-----------------------------------------------------
Fax | 818-333-1563
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | VAGRAM ANTONIAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-333-0880
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------