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General NPI Number Information
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NPI Number | 1245321751
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Entity Type | Organization
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Legal Business Name | LAVANDA HOME HEALTH CARE AGENCY INC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 01/25/2008
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Provider Practice Location Address
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Address Line | 11490 BURBANK BLVD #3E
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-2389
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Country | US
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Telephone | 818-760-9656
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Fax | 818-760-9635
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Provider Business Mailing Address
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Address Line | 2501 W BURBANK BLVD SUITE 312
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City | BURBANK
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State | CA
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Zip | 91505-2347
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Country | US
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Telephone | 818-840-0003
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Fax | 818-840-0069
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Authorized Official
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Title or Position | CEO
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Name | NATHAN JULIAN
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Credential |
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Telephone | 818-840-0003
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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 | 980001555
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License Number State | CA
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