Provider Demographics
NPI:1598414187
Name:ADVANCE LIFE HOME HEALTH INC
Entity Type:Organization
Organization Name:ADVANCE LIFE HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SARKIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KSACHIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-264-4040
Mailing Address - Street 1:14547 TITUS ST STE 104
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4913
Mailing Address - Country:US
Mailing Address - Phone:818-264-4040
Mailing Address - Fax:
Practice Address - Street 1:14547 TITUS ST STE 104
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4913
Practice Address - Country:US
Practice Address - Phone:818-264-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health