Provider Demographics
NPI:1952646952
Name:DEISTIC HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:DEISTIC HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HERMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KESHISHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-649-1475
Mailing Address - Street 1:4250 PENNSYLVANIA AVE.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3369
Mailing Address - Country:US
Mailing Address - Phone:818-649-1475
Mailing Address - Fax:818-649-1476
Practice Address - Street 1:4250 PENNSYLVANIA AVE.
Practice Address - Street 2:SUITE 101
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-3369
Practice Address - Country:US
Practice Address - Phone:818-649-1475
Practice Address - Fax:818-649-1476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-01
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health