Provider Demographics
NPI:1659031813
Name:PROUD TO SERVE HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:PROUD TO SERVE HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURADYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-646-0273
Mailing Address - Street 1:14401 GILMORE ST # 201A
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6231
Mailing Address - Country:US
Mailing Address - Phone:818-646-0273
Mailing Address - Fax:818-646-0274
Practice Address - Street 1:14401 GILMORE ST # 201A
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-6231
Practice Address - Country:US
Practice Address - Phone:818-646-0273
Practice Address - Fax:818-646-0274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health