Provider Demographics
NPI:1700533965
Name:SOULISTIC HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:SOULISTIC HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KHACHIK
Authorized Official - Middle Name:
Authorized Official - Last Name:GLNJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-268-7430
Mailing Address - Street 1:3638 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-1738
Mailing Address - Country:US
Mailing Address - Phone:747-268-7430
Mailing Address - Fax:747-268-7433
Practice Address - Street 1:3638 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-1738
Practice Address - Country:US
Practice Address - Phone:747-268-7430
Practice Address - Fax:747-268-7433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health