Provider Demographics
NPI:1346824539
Name:LAGOONA HOME HEALTH AGENCY, INC
Entity Type:Organization
Organization Name:LAGOONA HOME HEALTH AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROUZANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARKISIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-510-0041
Mailing Address - Street 1:6360 VAN NUYS BLVD STE 229
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6360 VAN NUYS BLVD STE 229
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-6615
Practice Address - Country:US
Practice Address - Phone:818-510-0041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health