Provider Demographics
NPI:1205417466
Name:HOLY LIGHT HOME HEALTH, INC.
Entity type:Organization
Organization Name:HOLY LIGHT HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARUTYUNYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-345-9069
Mailing Address - Street 1:14545 FRIAR ST STE 362
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2397
Mailing Address - Country:US
Mailing Address - Phone:818-345-9069
Mailing Address - Fax:
Practice Address - Street 1:14545 FRIAR ST STE 362
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2397
Practice Address - Country:US
Practice Address - Phone:818-345-9069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNDRELEX MANAGEMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-19
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based