Provider Demographics
NPI:1902196199
Name:JOLIE HOME HEALTH AGENCY, INC.
Entity Type:Organization
Organization Name:JOLIE HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAYANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERBERYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-624-8869
Mailing Address - Street 1:8905 GLENOAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2038
Mailing Address - Country:US
Mailing Address - Phone:818-624-8869
Mailing Address - Fax:818-785-9686
Practice Address - Street 1:8905 GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-2038
Practice Address - Country:US
Practice Address - Phone:818-624-8869
Practice Address - Fax:818-785-9686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-09
Last Update Date:2011-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health