Provider Demographics
NPI:1942046701
Name:PROFESSIONAL HELP HOME HEALTH
Entity type:Organization
Organization Name:PROFESSIONAL HELP HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VARDANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:818-744-1911
Mailing Address - Street 1:869 E FOOTHILL BLVD STE K
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4063
Mailing Address - Country:US
Mailing Address - Phone:310-363-0632
Mailing Address - Fax:818-279-7195
Practice Address - Street 1:869 E FOOTHILL BLVD STE K
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4063
Practice Address - Country:US
Practice Address - Phone:310-363-0632
Practice Address - Fax:818-279-7195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health