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NPI 1245906502

NPI 1245906502 : ENCINO HOME INC : ENCINO, CA

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General NPI Number Information
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    NPI Number           |    1245906502
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    Entity Type          |    Organization 
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    Legal Business Name  |    ENCINO HOME INC 
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Dates
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    Enumeration Date     |    08/17/2021
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    Last Update Date     |    08/17/2021
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Provider Practice Location Address
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    Address Line         |    18075 VENTURA BLVD STE 110 
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    City                 |    ENCINO
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    State                |    CA
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    Zip                  |    91316-3599
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    Country              |    US
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    Telephone            |    818-666-8039
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    Fax                  |    717-710-7798
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Provider Business Mailing Address
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    Address Line         |    18075 VENTURA BLVD STE 110 
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    City                 |    ENCINO
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    State                |    CA
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    Zip                  |    91316-3599
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    Country              |    US
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    Telephone            |    818-666-8039
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    Fax                  |    717-710-7798
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    MISS MARINA  ANANYAN 
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    Credential           |    
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    Telephone            |    818-666-8039
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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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