=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487144820
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BELANI HOME HEALTH CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2018
-----------------------------------------------------
Last Update Date | 09/11/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2609 W WYOMING AVE STE B
-----------------------------------------------------
City | BURBANK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91505-1950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-835-7986
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10137 RIVERSIDE DR STE 201
-----------------------------------------------------
City | TOLUCA LAKE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91602-2509
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-835-7986
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | NELLI YAZICHYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-835-7986
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------