Provider Demographics
NPI:1881127215
Name:ADVANCED WELLNESS HOME CARE INC.
Entity type:Organization
Organization Name:ADVANCED WELLNESS HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHOGHIK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-524-9390
Mailing Address - Street 1:4959 PALO VERDE ST STE 206C-5
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2341
Mailing Address - Country:US
Mailing Address - Phone:626-524-9390
Mailing Address - Fax:626-798-2946
Practice Address - Street 1:4959 PALO VERDE ST STE 206C-5
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2341
Practice Address - Country:US
Practice Address - Phone:626-524-9390
Practice Address - Fax:626-798-2946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based