Provider Demographics
NPI:1790143097
Name:V A HOME HEALTH 1 INC
Entity Type:Organization
Organization Name:V A HOME HEALTH 1 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHADIMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-824-3577
Mailing Address - Street 1:6710 N 47TH AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-4111
Mailing Address - Country:US
Mailing Address - Phone:844-824-3577
Mailing Address - Fax:844-329-8682
Practice Address - Street 1:6718 W GREENWAY RD
Practice Address - Street 2:SUITE 208
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4583
Practice Address - Country:US
Practice Address - Phone:844-824-3577
Practice Address - Fax:844-329-8682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA6215251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health