Provider Demographics
NPI:1306519442
Name:DEGA HOME HEALTH
Entity type:Organization
Organization Name:DEGA HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPATOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-744-2474
Mailing Address - Street 1:6356 VAN NUYS BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-2627
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6356 VAN NUYS BLVD STE 240
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-2627
Practice Address - Country:US
Practice Address - Phone:818-744-2474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEGA HOSPICE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health