Provider Demographics
NPI:1528815909
Name:PLATINUM HOME HEALTH AGENCY
Entity type:Organization
Organization Name:PLATINUM HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVOURK
Authorized Official - Middle Name:
Authorized Official - Last Name:POGHOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-674-7564
Mailing Address - Street 1:19634 VENTURA BLVD STE 313
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3131
Mailing Address - Country:US
Mailing Address - Phone:818-674-7564
Mailing Address - Fax:818-674-7564
Practice Address - Street 1:19634 VENTURA BLVD STE 313
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3131
Practice Address - Country:US
Practice Address - Phone:818-674-7564
Practice Address - Fax:818-674-7564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health