MEDICARE: MINORU HOME CARE,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	:	1861248544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINORU HOME CARE,INC

Provider Business Mailing Address
First Line	:	2073 MINORU DR
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-3417
Country	:	US
Telephone Number	:	626-630-2666
Fax Number	:

Provider Business Practice Location Address
First Line	:	2073 MINORU DR
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-3417
Country	:	US
Telephone Number	:	626-630-2666
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. NARINE KELESHYAN
Credential	:
Telephone Number	:	626-630-2666

Provider Enumeration Date	:	04/24/2024
Last Update Date	:	04/24/2024

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Directions to “MINORU HOME CARE,INC ” Practice Location

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