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General NPI Number Information
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NPI Number | 1992219463
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Entity Type | Organization
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Legal Business Name | EAGLE HOME HEALTH
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 6005 VINELAND AVE STE 204
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-4984
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Country | US
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Telephone | 747-244-7340
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Fax |
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Provider Business Mailing Address
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Address Line | 6005 VINELAND AVE STE 204
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-4984
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Country | US
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Telephone | 818-927-4039
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LIANA GRIGORYAN
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Credential |
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Telephone | 818-927-4039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | CA
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