Provider Demographics
NPI:1205543642
Name:EXTENDED LIFE HOME HEALTH
Entity type:Organization
Organization Name:EXTENDED LIFE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAKELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-273-2585
Mailing Address - Street 1:28310 ROADSIDE DR STE 138
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4960
Mailing Address - Country:US
Mailing Address - Phone:800-273-2585
Mailing Address - Fax:800-273-2585
Practice Address - Street 1:28310 ROADSIDE DR STE 138
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4960
Practice Address - Country:US
Practice Address - Phone:800-273-2585
Practice Address - Fax:800-273-2585
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELHH INVESTMENTS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health