Provider Demographics
NPI:1053986695
Name:ETERNITY HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:ETERNITY HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/TREASURER/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGHAJANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-254-3300
Mailing Address - Street 1:14545 FRIAR ST STE 319
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2397
Mailing Address - Country:US
Mailing Address - Phone:747-254-3300
Mailing Address - Fax:800-273-0933
Practice Address - Street 1:14545 FRIAR ST STE 319
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2397
Practice Address - Country:US
Practice Address - Phone:747-254-3300
Practice Address - Fax:800-273-0933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health