Provider Demographics
NPI:1902556624
Name:ETERNAL HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:ETERNAL HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MERI
Authorized Official - Middle Name:
Authorized Official - Last Name:KHUDASHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-212-4540
Mailing Address - Street 1:2600 FOOTHILL BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-4579
Mailing Address - Country:US
Mailing Address - Phone:747-212-4540
Mailing Address - Fax:747-212-4541
Practice Address - Street 1:2600 FOOTHILL BLVD STE 208
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-4579
Practice Address - Country:US
Practice Address - Phone:747-212-4540
Practice Address - Fax:747-212-4541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health