=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285252825
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALMAZ HHA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/09/2020
-----------------------------------------------------
Last Update Date | 07/09/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 35325 DATE PALM DR STE 152D
-----------------------------------------------------
City | CATHEDRAL CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92234-7008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-442-2686
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1007 RALEIGH ST APT 209
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91205-4261
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-442-2686
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | MARAT ARUTUNYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-442-2686
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------