Provider Demographics
NPI:1407461668
Name:HEALTHY WAY HOME HEALTH
Entity Type:Organization
Organization Name:HEALTHY WAY HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:EDILYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-392-6636
Mailing Address - Street 1:6320 VAN NUYS BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6610
Mailing Address - Country:US
Mailing Address - Phone:818-392-6636
Mailing Address - Fax:
Practice Address - Street 1:6320 VAN NUYS BLVD STE 207
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-6610
Practice Address - Country:US
Practice Address - Phone:818-392-6636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHY WAY HEALTHCARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-14
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health