Provider Demographics
NPI:1811591449
Name:TRG HOME HEALTH
Entity Type:Organization
Organization Name:TRG HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIGRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VASILYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-796-4745
Mailing Address - Street 1:7034 VAN NUYS BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-3060
Mailing Address - Country:US
Mailing Address - Phone:818-796-4745
Mailing Address - Fax:
Practice Address - Street 1:7034 VAN NUYS BLVD STE 204
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3060
Practice Address - Country:US
Practice Address - Phone:818-796-4745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health