=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972672996
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CALIPSO HOME HEALTH CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/06/2006
-----------------------------------------------------
Last Update Date | 03/13/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16909 PARTHENIA ST STE 205
-----------------------------------------------------
City | NORTHRIDGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91343-4578
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-894-8000
-----------------------------------------------------
Fax | 818-894-8001
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16909 PARTHENIA ST STE 205
-----------------------------------------------------
City | NORTHRIDGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91343-4578
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-894-8000
-----------------------------------------------------
Fax | 818-894-8001
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ARMENAK ZAKARYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-894-8000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 550000167
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------