MEDICARE: ADONAI HOME HEALTH CARE 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	:	1053912436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADONAI HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	356 W COLORADO ST STE A
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-1603
Country	:	US
Telephone Number	:	818-480-6526
Fax Number	:	818-688-3806

Provider Business Practice Location Address
First Line	:	356 W COLORADO ST STE A
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-1603
Country	:	US
Telephone Number	:	818-480-6526
Fax Number	:	818-688-3806

Authorized Official
Title or Position	:	CEO
Name	:	HAKOP JACK GEVORGYAN
Credential	:
Telephone Number	:	818-480-6526

Provider Enumeration Date	:	11/03/2020
Last Update Date	:	05/12/2026

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