MEDICARE: ELITE BENEFITS HOME HEALTH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1043151830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE BENEFITS HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	121 W LEXINGTON DR STE L400B
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-3520
Country	:	US
Telephone Number	:	818-480-4805
Fax Number	:	818-480-6595

Provider Business Practice Location Address
First Line	:	121 W LEXINGTON DR STE L400B
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-3520
Country	:	US
Telephone Number	:	818-480-4805
Fax Number	:	818-480-6595

Authorized Official
Title or Position	:	CEO/CFO/SECRETARY
Name	:	DIANA TER-GRIGORYAN
Credential	:
Telephone Number	:	818-480-4805

Provider Enumeration Date	:	04/03/2026
Last Update Date	:	04/03/2026

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