Provider Demographics
NPI:1275566952
Name:CONCORD HOME HEALTH CARE
Entity Type:Organization
Organization Name:CONCORD HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANOUSHAK
Authorized Official - Middle Name:
Authorized Official - Last Name:AKHOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-792-0911
Mailing Address - Street 1:424 N LAKE AVE
Mailing Address - Street 2:#305
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101
Mailing Address - Country:US
Mailing Address - Phone:626-792-0911
Mailing Address - Fax:626-792-8911
Practice Address - Street 1:424 N LAKE AVE
Practice Address - Street 2:#305
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101
Practice Address - Country:US
Practice Address - Phone:626-792-0911
Practice Address - Fax:626-792-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
058218Medicare ID - Type Unspecified