MEDICARE: BROADVIEW 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	:	1205582905
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROADVIEW HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	517 E WILSON AVE STE 103B
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-4376
Country	:	US
Telephone Number	:	747-777-4491
Fax Number	:	747-777-5946

Provider Business Practice Location Address
First Line	:	517 E WILSON AVE STE 103B
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-4376
Country	:	US
Telephone Number	:	747-777-4491
Fax Number	:	747-777-5946

Authorized Official
Title or Position	:	PRESIDENT/ CEO
Name	:	MR. ARMEN BENYAMINYAN
Credential	:
Telephone Number	:	747-777-4491

Provider Enumeration Date	:	02/22/2022
Last Update Date	:	02/22/2022

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