Provider Demographics
NPI:1891391488
Name:SELAPHIEL HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:SELAPHIEL HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETROS
Authorized Official - Middle Name:
Authorized Official - Last Name:GUMRIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-800-4885
Mailing Address - Street 1:1160 N CENTRAL AVE UNIT 212A
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2510
Mailing Address - Country:US
Mailing Address - Phone:888-800-4885
Mailing Address - Fax:818-743-8707
Practice Address - Street 1:1160 N CENTRAL AVE UNIT 212A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2510
Practice Address - Country:US
Practice Address - Phone:888-800-4885
Practice Address - Fax:818-743-8707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health