Provider Demographics
NPI:1447810668
Name:GLENOAKS HOME HEALTH, INC.
Entity type:Organization
Organization Name:GLENOAKS HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGAKHANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-246-2121
Mailing Address - Street 1:1524 W GLENOAKS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1913
Mailing Address - Country:US
Mailing Address - Phone:818-246-2121
Mailing Address - Fax:
Practice Address - Street 1:1524 W GLENOAKS BLVD STE A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-1913
Practice Address - Country:US
Practice Address - Phone:818-246-2121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2020-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1Medicaid