MEDICARE: GENTLE HEART HOME CARE, 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	:	1740787373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTLE HEART HOME CARE, LLC

Provider Business Mailing Address
First Line	:	509 E WINDSOR RD
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-2307
Country	:	US
Telephone Number	:	818-425-7353
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 E WINDSOR RD
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-2307
Country	:	US
Telephone Number	:	818-425-7353
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDREAS KARAGUEZIAN
Credential	:
Telephone Number	:	818-425-7353

Provider Enumeration Date	:	04/10/2018
Last Update Date	:	04/10/2018

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