Provider Demographics
NPI:1659710598
Name:DESERT VALLEY HOME HEALTH, INC.
Entity Type:Organization
Organization Name:DESERT VALLEY HOME HEALTH, INC.
Other - Org Name:DESERT SKY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SARKISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-383-2555
Mailing Address - Street 1:12402 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE A-8
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-5871
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12241 INDUSTRIAL BLVD STE 106
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-7795
Practice Address - Country:US
Practice Address - Phone:760-383-2555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-24
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550002621251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059631Medicare Oscar/Certification