Provider Demographics
NPI:1699209734
Name:MK HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:MK HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:GHARAGYOZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-849-5684
Mailing Address - Street 1:14545 FRIAR ST
Mailing Address - Street 2:STE 117
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2397
Mailing Address - Country:US
Mailing Address - Phone:818-334-6243
Mailing Address - Fax:818-296-9594
Practice Address - Street 1:14545 FRIAR ST
Practice Address - Street 2:STE 117
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2397
Practice Address - Country:US
Practice Address - Phone:818-334-6243
Practice Address - Fax:818-296-9594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-15
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGOtherLICENSE NUMBER