Provider Demographics
NPI:1891966784
Name:INDEPENDENCE HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:INDEPENDENCE HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SLAVIK
Authorized Official - Middle Name:
Authorized Official - Last Name:AGEKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-551-9400
Mailing Address - Street 1:229 N CENTRAL AVE
Mailing Address - Street 2:#201
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-3507
Mailing Address - Country:US
Mailing Address - Phone:818-551-9400
Mailing Address - Fax:818-551-9401
Practice Address - Street 1:229 N CENTRAL AVE
Practice Address - Street 2:#201
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3507
Practice Address - Country:US
Practice Address - Phone:818-551-9400
Practice Address - Fax:818-551-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health