Provider Demographics
NPI:1750275285
Name:TEL AVIV HOME HEALTH CENTER LLC
Entity type:Organization
Organization Name:TEL AVIV HOME HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:VANUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKAYELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-888-8881
Mailing Address - Street 1:11633 VICTORY BLVD # 207B
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11633 VICTORY BLVD # 207B
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3513
Practice Address - Country:US
Practice Address - Phone:850-888-8881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health