Provider Demographics
NPI:1245417724
Name:GENERATIONS HOME HEALTH, INC.
Entity Type:Organization
Organization Name:GENERATIONS HOME HEALTH, INC.
Other - Org Name:BONUM OF OC HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VIRABOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-383-5380
Mailing Address - Street 1:2081 BUSINESS CENTER DR STE 128
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1115
Mailing Address - Country:US
Mailing Address - Phone:949-383-5380
Mailing Address - Fax:844-383-5381
Practice Address - Street 1:2081 BUSINESS CENTER DR STE 128
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1115
Practice Address - Country:US
Practice Address - Phone:949-383-5380
Practice Address - Fax:844-383-5381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-27
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000908251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059260Medicare Oscar/Certification