Provider Demographics
NPI:1245895523
Name:GOOD EARTH HOME HEALTH, INC.
Entity type:Organization
Organization Name:GOOD EARTH HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANJYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-502-9996
Mailing Address - Street 1:5015 EAGLE ROCK BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-2087
Mailing Address - Country:US
Mailing Address - Phone:323-274-4911
Mailing Address - Fax:323-274-4912
Practice Address - Street 1:13609 VICTORY BLVD
Practice Address - Street 2:SUITE 229
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-2087
Practice Address - Country:US
Practice Address - Phone:323-274-4911
Practice Address - Fax:323-274-4912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health