MEDICARE: ANGEL WINGS HOME HEALTH SERVICES, 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	:	1679150619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL WINGS HOME HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	6410 VAN NUYS BLVD STE F1
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-1449
Country	:	US
Telephone Number	:	424-226-9996
Fax Number	:	424-389-7573

Provider Business Practice Location Address
First Line	:	6410 VAN NUYS BLVD STE F1
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-1449
Country	:	US
Telephone Number	:	424-226-9996
Fax Number	:	424-389-7573

Authorized Official
Title or Position	:	CEO
Name	:	ASHOT N MELIKYAN
Credential	:
Telephone Number	:	424-226-9996

Provider Enumeration Date	:	03/25/2021
Last Update Date	:	07/22/2021

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Directions to “ANGEL WINGS HOME HEALTH SERVICES, INC ” Practice Location

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