MEDICARE: HEART TO HEART HOME HEALTH CARE AGENCY, LLC

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	:	1255899696
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART TO HEART HOME HEALTH CARE AGENCY, LLC

Provider Business Mailing Address
First Line	:	13231 N 35TH AVE STE 5A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-1233
Country	:	US
Telephone Number	:	602-354-8898
Fax Number	:	602-419-2919

Provider Business Practice Location Address
First Line	:	13231 N 35TH AVE STE 5A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-1233
Country	:	US
Telephone Number	:	602-354-8898
Fax Number	:	602-419-2919

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LILIT SEDRAKYAN
Credential	:	LCSW
Telephone Number	:	818-491-3333

Provider Enumeration Date	:	03/05/2019
Last Update Date	:	03/05/2019

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