Provider Demographics
NPI:1164006094
Name:BLOSSOM VALLEY HOME HEALT CARE
Entity Type:Organization
Organization Name:BLOSSOM VALLEY HOME HEALT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZHORA
Authorized Official - Middle Name:
Authorized Official - Last Name:JULHAKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-636-0941
Mailing Address - Street 1:14545 FRIAR ST STE 199-2
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2397
Mailing Address - Country:US
Mailing Address - Phone:818-636-0941
Mailing Address - Fax:
Practice Address - Street 1:14545 FRIAR ST STE 199-2
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2397
Practice Address - Country:US
Practice Address - Phone:818-636-0941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based