Provider Demographics
NPI:1720647498
Name:FIDELIS HOME HEALTH CARE
Entity Type:Organization
Organization Name:FIDELIS HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTAK
Authorized Official - Middle Name:
Authorized Official - Last Name:KHACHIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-265-0668
Mailing Address - Street 1:358 E OLIVE AVE UNIT 101
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1215
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:358 E OLIVE AVE UNIT 101
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1215
Practice Address - Country:US
Practice Address - Phone:747-265-0668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health