Provider Demographics
NPI:1932832821
Name:BLUE WAVES HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:BLUE WAVES 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:KYUREGHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-444-4476
Mailing Address - Street 1:7251 TOPANGA CANYON BLVD STE B2
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1269
Mailing Address - Country:US
Mailing Address - Phone:747-444-4476
Mailing Address - Fax:747-444-4305
Practice Address - Street 1:7251 TOPANGA CANYON BLVD STE B2
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1269
Practice Address - Country:US
Practice Address - Phone:747-444-4476
Practice Address - Fax:747-444-4305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health