=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992941231
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GUARDIAN HOME HEALTH, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2008
-----------------------------------------------------
Last Update Date | 12/16/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1101 E BROADWAY SUITE 107
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91205-1383
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-291-8444
-----------------------------------------------------
Fax | 818-291-8443
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1101 E BROADWAY SUITE 107
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91205-1383
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-291-8444
-----------------------------------------------------
Fax | 818-291-8443
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/PRESIDENT
-----------------------------------------------------
Name | ARSEN MIKAYELYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-291-8444
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------