Provider Demographics
NPI:1730840059
Name:PROCARE FIRST HOME HEALTH,INC.
Entity type:Organization
Organization Name:PROCARE FIRST HOME HEALTH,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MHER
Authorized Official - Middle Name:
Authorized Official - Last Name:AVETYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-280-3449
Mailing Address - Street 1:18269 PARTHENIA ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-3303
Mailing Address - Country:US
Mailing Address - Phone:818-280-3449
Mailing Address - Fax:
Practice Address - Street 1:18269 PARTHENIA ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-3303
Practice Address - Country:US
Practice Address - Phone:818-280-3449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-08
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health