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General NPI Number Information
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NPI Number | 1245727783
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Entity Type | Organization
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Legal Business Name | AVICENNA HOME HEALTH, INC.
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 17915 VENTURA BLVD STE 222
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City | ENCINO
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State | CA
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Zip | 91316-4811
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Country | US
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Telephone | 323-559-7915
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Fax | 424-652-5422
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Provider Business Mailing Address
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Address Line | 17915 VENTURA BLVD STE 222
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City | ENCINO
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State | CA
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Zip | 91316-4811
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Country | US
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Telephone | 323-559-7915
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Fax | 424-652-5422
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Authorized Official
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Title or Position | OWNER
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Name | MR. HARUTUN TAGARYAN
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Credential |
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Telephone | 747-282-1282
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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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