Provider Demographics
NPI:1528361607
Name:EGEIA HOME HEALTH, INC.
Entity Type:Organization
Organization Name:EGEIA HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-633-1374
Mailing Address - Street 1:1101 E BROADWAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1383
Mailing Address - Country:US
Mailing Address - Phone:818-633-1374
Mailing Address - Fax:818-765-7601
Practice Address - Street 1:1101 E BROADWAY
Practice Address - Street 2:SUITE 102
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1383
Practice Address - Country:US
Practice Address - Phone:818-633-1374
Practice Address - Fax:818-765-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059445Medicare Oscar/Certification