Provider Demographics
NPI:1053840785
Name:AMICI CARE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:AMICI CARE MANAGEMENT, LLC
Other - Org Name:AMICI HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOURADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-422-3919
Mailing Address - Street 1:1545 N VERDUGO RD STE 108
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-2858
Mailing Address - Country:US
Mailing Address - Phone:818-422-3919
Mailing Address - Fax:855-382-5717
Practice Address - Street 1:1545 N VERDUGO RD STE 108
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-2858
Practice Address - Country:US
Practice Address - Phone:818-422-3919
Practice Address - Fax:855-382-5717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-06
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health