Provider Demographics
NPI:1780259150
Name:ELK GROVE HOME HEALTH INC
Entity type:Organization
Organization Name:ELK GROVE HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LUSINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOVSISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-698-9803
Mailing Address - Street 1:2386 MARITIME DR STE 220
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-3643
Mailing Address - Country:US
Mailing Address - Phone:916-698-9803
Mailing Address - Fax:916-880-5313
Practice Address - Street 1:2386 MARITIME DR STE 220
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-3643
Practice Address - Country:US
Practice Address - Phone:916-698-9803
Practice Address - Fax:916-880-5313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health