MEDICARE: HOME HEALTH FOR LIFE 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	:	1295291813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME HEALTH FOR LIFE INC

Provider Business Mailing Address
First Line	:	2060 HUNTINGTON DR STE 9
Second Line	:
City	:	SAN MARINO
State	:	CA
Zip	:	91108-2044
Country	:	US
Telephone Number	:	626-539-9196
Fax Number	:

Provider Business Practice Location Address
First Line	:	2060 HUNTINGTON DR STE 9
Second Line	:
City	:	SAN MARINO
State	:	CA
Zip	:	91108-2044
Country	:	US
Telephone Number	:	626-539-9196
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LENA AZARYAN
Credential	:
Telephone Number	:	626-539-9196

Provider Enumeration Date	:	02/19/2019
Last Update Date	:	02/19/2019

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