Provider Demographics
NPI:1144347030
Name:UNITED HOME HEALTH AGENCY, INC.
Entity type:Organization
Organization Name:UNITED HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ILANGEZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-388-6030
Mailing Address - Street 1:12030 RIVERSIDE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3749
Mailing Address - Country:US
Mailing Address - Phone:818-755-8777
Mailing Address - Fax:818-755-8711
Practice Address - Street 1:12030 RIVERSIDE DR
Practice Address - Street 2:SUITE B
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91607-3749
Practice Address - Country:US
Practice Address - Phone:818-755-8777
Practice Address - Fax:818-755-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059052Medicare Oscar/Certification