=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720734528
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SILVER LINE HEALTH SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/01/2022
-----------------------------------------------------
Last Update Date | 03/04/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18039 CRENSHAW BLVD STE 303
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90504-5135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-374-5533
-----------------------------------------------------
Fax | 310-953-4842
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18039 CRENSHAW BLVD STE 303
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90504-5135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-374-5533
-----------------------------------------------------
Fax | 310-953-4842
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. DAVIT AGHEKYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 310-526-5276
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------