MEDICARE: JADE HEALTH VENTURES, 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	:	1780035121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JADE HEALTH VENTURES, INC

Provider Business Mailing Address
First Line	:	1226 N BRIGHTON ST
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91506-1202
Country	:	US
Telephone Number	:	213-400-0022
Fax Number	:	323-663-8455

Provider Business Practice Location Address
First Line	:	1226 N BRIGHTON ST
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91506-1202
Country	:	US
Telephone Number	:	213-400-0022
Fax Number	:	323-663-8455

Authorized Official
Title or Position	:	CEO
Name	:	GEVORK YARALYAN
Credential	:
Telephone Number	:	213-400-0022

Provider Enumeration Date	:	06/27/2016
Last Update Date	:	06/27/2016

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Directions to “JADE HEALTH VENTURES, INC ” Practice Location

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