Provider Demographics
NPI:1235691452
Name:VELVET HEARTS PROFESSIONAL HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:VELVET HEARTS PROFESSIONAL HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGHAVI
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NUSE
Authorized Official - Phone:805-573-1986
Mailing Address - Street 1:409 CALLE VERACRUZ
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320
Mailing Address - Country:US
Mailing Address - Phone:805-573-1986
Mailing Address - Fax:
Practice Address - Street 1:409 CALLE VERACRUZ
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320
Practice Address - Country:US
Practice Address - Phone:805-573-1986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VELVET HEARTS PROFESSIONAL HOMECARE AGENCY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty