Provider Demographics
NPI:1538827480
Name:EMERALD HEARTS HEALTHCARE
Entity type:Organization
Organization Name:EMERALD HEARTS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ILONA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIKOIANTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-745-8607
Mailing Address - Street 1:19626 VENTURA BLVD UNIT 220A
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2944
Mailing Address - Country:US
Mailing Address - Phone:818-745-8607
Mailing Address - Fax:833-631-2183
Practice Address - Street 1:19626 VENTURA BLVD UNIT 220A
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2944
Practice Address - Country:US
Practice Address - Phone:818-745-8607
Practice Address - Fax:833-631-2183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health