Provider Demographics
NPI:1912559915
Name:MG HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:MG HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAMAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HARUTYUNYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-650-8121
Mailing Address - Street 1:13758 VICTORY BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6731
Mailing Address - Country:US
Mailing Address - Phone:818-650-8121
Mailing Address - Fax:818-650-8127
Practice Address - Street 1:15643 SHERMAN WAY STE 200B
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-4135
Practice Address - Country:US
Practice Address - Phone:818-650-8121
Practice Address - Fax:818-650-8127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-10
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health