MEDICARE: MG 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1871011940
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MG HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	8119 FOOTHILL BLVD STE 6
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-3600
Country	:	US
Telephone Number	:	818-643-7020
Fax Number	:	818-643-7120

Provider Business Practice Location Address
First Line	:	8119 FOOTHILL BLVD STE 6
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-3600
Country	:	US
Telephone Number	:	818-643-7020
Fax Number	:	818-643-7120

Authorized Official
Title or Position	:	CEO
Name	:	GRIGOR AYVAZYAN
Credential	:
Telephone Number	:	818-643-7020

Provider Enumeration Date	:	09/08/2017
Last Update Date	:	07/21/2022

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Directions to “MG HOME HEALTH, INC. ” Practice Location

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