Provider Demographics
NPI:1457879561
Name:PENTA HOME HEALTH AGENCY, INC.
Entity Type:Organization
Organization Name:PENTA HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-922-4040
Mailing Address - Street 1:7036 FOOTHILL BLVD UNIT C
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2715
Mailing Address - Country:US
Mailing Address - Phone:818-922-4040
Mailing Address - Fax:
Practice Address - Street 1:7036 FOOTHILL BLVD UNIT C
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2715
Practice Address - Country:US
Practice Address - Phone:818-922-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health