Provider Demographics
NPI:1720243538
Name:ELAN HOME HEALTH, INC.
Entity Type:Organization
Organization Name:ELAN HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDUARD
Authorized Official - Middle Name:
Authorized Official - Last Name:POGHOSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-891-7111
Mailing Address - Street 1:9608 VAN NUYS BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-1043
Mailing Address - Country:US
Mailing Address - Phone:818-891-7111
Mailing Address - Fax:818-891-0077
Practice Address - Street 1:9608 VAN NUYS BLVD STE 204
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-1043
Practice Address - Country:US
Practice Address - Phone:818-891-7111
Practice Address - Fax:818-891-0077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000967251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059199Medicare Oscar/Certification