=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902554058
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HT HOME HEALTH INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2022
-----------------------------------------------------
Last Update Date | 03/16/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1800 BROADVIEW DRIVE STE 260-A
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 747-307-5570
-----------------------------------------------------
Fax | 747-313-7463
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1800 BROADVIEW DRIVE STE 260-A
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 747-307-5570
-----------------------------------------------------
Fax | 747-313-7463
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO,CFO,SECRETARY
-----------------------------------------------------
Name | HAYK TARVERDYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 747-307-5570
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------