Provider Demographics
NPI:1063926830
Name:MMA HOME HEALTH CARE INC
Entity type:Organization
Organization Name:MMA HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:AVETISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-260-9975
Mailing Address - Street 1:3800 W BURBANK BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2148
Mailing Address - Country:US
Mailing Address - Phone:747-240-6100
Mailing Address - Fax:747-240-6099
Practice Address - Street 1:3800 W BURBANK BLVD STE 105
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2148
Practice Address - Country:US
Practice Address - Phone:747-240-6100
Practice Address - Fax:747-240-6099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-30
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health