Provider Demographics
NPI:1780035121
Name:JADE HEALTH VENTURES, INC
Entity Type:Organization
Organization Name:JADE HEALTH VENTURES, INC
Other - Org Name:FOUNTAIN HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEVORK
Authorized Official - Middle Name:
Authorized Official - Last Name:YARALYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-400-0022
Mailing Address - Street 1:1226 N BRIGHTON ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1202
Mailing Address - Country:US
Mailing Address - Phone:213-400-0022
Mailing Address - Fax:323-663-8455
Practice Address - Street 1:1226 N BRIGHTON ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1202
Practice Address - Country:US
Practice Address - Phone:213-400-0022
Practice Address - Fax:323-663-8455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health