MEDICARE: KEY TO HEALTH HOMECARE, 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	:	1548703291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEY TO HEALTH HOMECARE, INC.

Provider Business Mailing Address
First Line	:	9608 VAN NUYS BLVD STE 202
Second Line	:
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-1043
Country	:	US
Telephone Number	:	323-844-2060
Fax Number	:	323-794-2070

Provider Business Practice Location Address
First Line	:	9608 VAN NUYS BLVD STE 202
Second Line	:
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-1043
Country	:	US
Telephone Number	:	323-844-2060
Fax Number	:	323-794-2070

Authorized Official
Title or Position	:	CEO
Name	:	ALVARD AVAGYAN
Credential	:
Telephone Number	:	323-844-2060

Provider Enumeration Date	:	11/29/2016
Last Update Date	:	11/29/2016

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