Provider Demographics
NPI:1366777567
Name:ALPHA HOME HEALTH
Entity type:Organization
Organization Name:ALPHA HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDVARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GEVORGYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-800-0144
Mailing Address - Street 1:3333 CONCOURS BLDG 7
Mailing Address - Street 2:SUITE 7100
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-4875
Mailing Address - Country:US
Mailing Address - Phone:909-466-8200
Mailing Address - Fax:909-466-8225
Practice Address - Street 1:3333 CONCOURS BLDG 7
Practice Address - Street 2:SUITE 7100
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-4875
Practice Address - Country:US
Practice Address - Phone:909-466-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001117251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health