Provider Demographics
NPI:1316529167
Name:PRESTIGE LIFE HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:PRESTIGE LIFE HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LILIT
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUNIATIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-444-9146
Mailing Address - Street 1:5311 TOPANGA CANYON BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1754
Mailing Address - Country:US
Mailing Address - Phone:747-444-9146
Mailing Address - Fax:818-960-0290
Practice Address - Street 1:5311 TOPANGA CANYON BLVD STE 208
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1754
Practice Address - Country:US
Practice Address - Phone:747-444-9146
Practice Address - Fax:818-960-0290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health