Provider Demographics
NPI:1417620584
Name:STARS AND STRIPES HOME HEALTH
Entity Type:Organization
Organization Name:STARS AND STRIPES HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VARDUHI
Authorized Official - Middle Name:
Authorized Official - Last Name:TOVMASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-282-0865
Mailing Address - Street 1:4605 LANKERSHIM BLVD STE 209A
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91602-1874
Mailing Address - Country:US
Mailing Address - Phone:747-282-0865
Mailing Address - Fax:747-282-0866
Practice Address - Street 1:4605 LANKERSHIM BLVD STE 209A
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-1874
Practice Address - Country:US
Practice Address - Phone:747-282-0865
Practice Address - Fax:747-282-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health