Provider Demographics
NPI:1144783358
Name:LIBERTY HOME HEALTH CARE
Entity type:Organization
Organization Name:LIBERTY HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SERGEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KALAJYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-303-3003
Mailing Address - Street 1:7226 SEPULVEDA BLVD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2003
Mailing Address - Country:US
Mailing Address - Phone:323-303-3003
Mailing Address - Fax:800-866-4791
Practice Address - Street 1:14407 GILMORE ST STE 202
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1400
Practice Address - Country:US
Practice Address - Phone:323-303-3003
Practice Address - Fax:800-866-4791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-13
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health