Provider Demographics
NPI:1447903091
Name:PEACEFUL HARBORS HOME HEALTH, INC.
Entity type:Organization
Organization Name:PEACEFUL HARBORS HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:VARDANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-336-9648
Mailing Address - Street 1:5311 TOPANGA CANYON BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1754
Mailing Address - Country:US
Mailing Address - Phone:747-336-9648
Mailing Address - Fax:
Practice Address - Street 1:5311 TOPANGA CANYON BLVD STE 209
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1754
Practice Address - Country:US
Practice Address - Phone:747-336-9648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KVS INVESTMENTS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health