Provider Demographics
NPI:1275102865
Name:THREE OLIVES HOME HEALTH CORP
Entity Type:Organization
Organization Name:THREE OLIVES HOME HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LILIT
Authorized Official - Middle Name:
Authorized Official - Last Name:AZATYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-600-2081
Mailing Address - Street 1:6949 RESEDA BLVD UNIT 201A
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-8537
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6949 RESEDA BLVD UNIT 201A
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-8537
Practice Address - Country:US
Practice Address - Phone:818-600-2081
Practice Address - Fax:818-578-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-18
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health