Provider Demographics
NPI:1588227565
Name:LONG LIFE HOME HEALTH, INC
Entity Type:Organization
Organization Name:LONG LIFE HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LILIT
Authorized Official - Middle Name:
Authorized Official - Last Name:HARUYUNYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-649-1888
Mailing Address - Street 1:400 S GLENDALE AVE STE N
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-2284
Mailing Address - Country:US
Mailing Address - Phone:818-649-1888
Mailing Address - Fax:818-649-1889
Practice Address - Street 1:400 S GLENDALE AVE UNIT 3
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-2283
Practice Address - Country:US
Practice Address - Phone:818-649-1888
Practice Address - Fax:818-649-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health