Provider Demographics
NPI:1306402847
Name:EXCELLENT HOME HEALTH AGENCY INC
Entity Type:Organization
Organization Name:EXCELLENT HOME HEALTH AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUZANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-935-1687
Mailing Address - Street 1:4220 E LOS ANGELES AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3305
Mailing Address - Country:US
Mailing Address - Phone:818-935-1687
Mailing Address - Fax:
Practice Address - Street 1:4220 E LOS ANGELES AVE STE 102
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3305
Practice Address - Country:US
Practice Address - Phone:818-935-1687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health