=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376113118
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VITAGOLD HOME HEALTH CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2021
-----------------------------------------------------
Last Update Date | 06/24/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24881 RAILROAD AVE STE 205
-----------------------------------------------------
City | SANTA CLARITA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91321-1589
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-431-0404
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24881 RAILROAD AVE STE 205
-----------------------------------------------------
City | SANTA CLARITA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91321-1589
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-431-0404
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ARA ASOYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-431-0404
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------