Provider Demographics
NPI:1275278103
Name:ALTADENA HOME HEALTH
Entity Type:Organization
Organization Name:ALTADENA HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASTRIK
Authorized Official - Middle Name:
Authorized Official - Last Name:ORUDYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-771-9619
Mailing Address - Street 1:2055 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-2444
Mailing Address - Country:US
Mailing Address - Phone:626-771-9619
Mailing Address - Fax:
Practice Address - Street 1:2055 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-2444
Practice Address - Country:US
Practice Address - Phone:626-771-9619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health