MEDICARE: WOODLYN 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1720542236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODLYN HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	728 S HILL ST STE 605B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90014-2768
Country	:	US
Telephone Number	:	323-230-4525
Fax Number	:	323-230-4515

Provider Business Practice Location Address
First Line	:	728 S HILL ST STE 605B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90014-2768
Country	:	US
Telephone Number	:	323-230-4525
Fax Number	:	323-230-4515

Authorized Official
Title or Position	:	CEO
Name	:	MR. BAGDASAR GALADJIAN
Credential	:
Telephone Number	:	323-230-4525

Provider Enumeration Date	:	01/29/2019
Last Update Date	:	01/29/2019

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