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General NPI Number Information
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NPI Number | 1225207020
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Entity Type | Organization
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Legal Business Name | MAGNOLIA HOME HEALTH CARE SERVICES, INC
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 11/12/2010
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Provider Practice Location Address
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Address Line | 120 S VICTORY BLVD SUITE 203
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City | BURBANK
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State | CA
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Zip | 91502-2801
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Country | US
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Telephone | 818-566-4411
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Fax | 818-566-4404
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Provider Business Mailing Address
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Address Line | 120 S VICTORY BLVD SUITE 203
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City | BURBANK
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State | CA
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Zip | 91502-2801
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Country | US
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Telephone | 818-566-4411
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Fax | 818-566-4404
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | ARMENUHI AMY KESHISHYAN
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Credential |
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Telephone | 818-566-4411
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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 | 550001035
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License Number State | CA
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