Provider Demographics
NPI:1215652433
Name:HOME LIFE HEALTHCARE
Entity type:Organization
Organization Name:HOME LIFE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HRAYR
Authorized Official - Middle Name:
Authorized Official - Last Name:SARGSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-647-1487
Mailing Address - Street 1:12444 VICTORY BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3156
Mailing Address - Country:US
Mailing Address - Phone:818-647-1487
Mailing Address - Fax:818-286-3951
Practice Address - Street 1:12444 VICTORY BLVD STE 111
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3156
Practice Address - Country:US
Practice Address - Phone:818-647-1487
Practice Address - Fax:818-286-3951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health