Provider Demographics
NPI:1033675665
Name:QUEEN OF THE VALLEY HOME HEALTH, INC.
Entity Type:Organization
Organization Name:QUEEN OF THE VALLEY HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHECHUMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-240-3727
Mailing Address - Street 1:8777 SAN FERNANDO RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-1406
Mailing Address - Country:US
Mailing Address - Phone:747-240-3727
Mailing Address - Fax:
Practice Address - Street 1:8777 SAN FERNANDO RD STE 200
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-1406
Practice Address - Country:US
Practice Address - Phone:747-240-3727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health