MEDICARE: IDEAL 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	:	1104597822
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IDEAL HOME HEALTH INC

Provider Business Mailing Address
First Line	:	6849 W CHARLESTON BLVD STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1649
Country	:	US
Telephone Number	:	702-863-8502
Fax Number	:	818-806-3400

Provider Business Practice Location Address
First Line	:	6849 W CHARLESTON BLVD STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1649
Country	:	US
Telephone Number	:	702-863-8502
Fax Number	:	818-806-3400

Authorized Official
Title or Position	:	CEO
Name	:	EDVARD BABAKHANYAN
Credential	:
Telephone Number	:	702-863-8502

Provider Enumeration Date	:	09/22/2021
Last Update Date	:	09/22/2021

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Directions to “IDEAL HOME HEALTH INC ” Practice Location

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