Provider Demographics
NPI:1679214910
Name:MOUNT HOPE HOME HEALTH CORP.
Entity Type:Organization
Organization Name:MOUNT HOPE HOME HEALTH CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMVALIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-402-7759
Mailing Address - Street 1:716 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1010
Mailing Address - Country:US
Mailing Address - Phone:818-434-2518
Mailing Address - Fax:
Practice Address - Street 1:66525 PIERSON BLVD SPC 1
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-3756
Practice Address - Country:US
Practice Address - Phone:760-614-2066
Practice Address - Fax:760-614-2067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health