Provider Demographics
NPI:1982347175
Name:BLUE HORIZON HOME HEALTH CARE
Entity Type:Organization
Organization Name:BLUE HORIZON HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:
Authorized Official - Last Name:TUPINYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-331-4949
Mailing Address - Street 1:2505 FOOTHILL BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-4555
Mailing Address - Country:US
Mailing Address - Phone:818-732-4214
Mailing Address - Fax:818-732-4298
Practice Address - Street 1:2505 FOOTHILL BLVD STE D
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-4555
Practice Address - Country:US
Practice Address - Phone:818-732-4214
Practice Address - Fax:818-732-4298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health