Provider Demographics
NPI:1710695416
Name:PRIMARY HOME HEALTH, INC.
Entity Type:Organization
Organization Name:PRIMARY HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATEVOS
Authorized Official - Middle Name:
Authorized Official - Last Name:KELESHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-962-0750
Mailing Address - Street 1:30941 AGOURA RD STE 222
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4660
Mailing Address - Country:US
Mailing Address - Phone:818-962-0750
Mailing Address - Fax:818-962-0750
Practice Address - Street 1:30941 AGOURA RD STE 222
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4660
Practice Address - Country:US
Practice Address - Phone:818-962-0750
Practice Address - Fax:818-962-0750
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHH INVESTMENTS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-10
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health