MEDICARE: ELLIOT HOME CARE

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	:	1942923495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELLIOT HOME CARE

Provider Business Mailing Address
First Line	:	416 N GLENDALE AVE STE 204A
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-3327
Country	:	US
Telephone Number	:	818-396-9598
Fax Number	:	818-474-4538

Provider Business Practice Location Address
First Line	:	416 N GLENDALE AVE STE 204A
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-3327
Country	:	US
Telephone Number	:	818-396-9598
Fax Number	:	818-474-4538

Authorized Official
Title or Position	:	CEO
Name	:	ZARUHI HOUSYAN
Credential	:
Telephone Number	:	818-396-9598

Provider Enumeration Date	:	09/20/2022
Last Update Date	:	09/20/2022

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Directions to “ELLIOT HOME CARE ” Practice Location

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