Provider Demographics
NPI:1225140098
Name:GOLDEN HEART HOME HEALTH CARE
Entity Type:Organization
Organization Name:GOLDEN HEART HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-957-0009
Mailing Address - Street 1:3539 OCEAN VIEW BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-3409
Mailing Address - Country:US
Mailing Address - Phone:818-957-0009
Mailing Address - Fax:818-957-0004
Practice Address - Street 1:3539 OCEAN VIEW BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-3409
Practice Address - Country:US
Practice Address - Phone:818-957-0009
Practice Address - Fax:818-957-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001505251E00000X
CA05D1010294291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No291U00000XLaboratoriesClinical Medical Laboratory