Provider Demographics
NPI:1487302139
Name:SPIKE HOME HEALTH CARE
Entity type:Organization
Organization Name:SPIKE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEVORG
Authorized Official - Middle Name:
Authorized Official - Last Name:KHACHATRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-630-9599
Mailing Address - Street 1:4119 W BURBANK BLVD STE 135
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2122
Mailing Address - Country:US
Mailing Address - Phone:818-630-9599
Mailing Address - Fax:818-630-9599
Practice Address - Street 1:4119 W BURBANK BLVD STE 135
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2122
Practice Address - Country:US
Practice Address - Phone:818-630-9599
Practice Address - Fax:818-630-9599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health