Provider Demographics
NPI:1871193169
Name:SUPREME HOME CARE SERVICES INC
Entity Type:Organization
Organization Name:SUPREME HOME CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAHAK
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHAKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-395-4141
Mailing Address - Street 1:4119 W BURBANK BLVD STE 182
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2122
Mailing Address - Country:US
Mailing Address - Phone:818-395-4141
Mailing Address - Fax:
Practice Address - Street 1:4119 W BURBANK BLVD STE 182
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2122
Practice Address - Country:US
Practice Address - Phone:818-395-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOYFUL HEAVEN INVESTMENTS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health