Provider Demographics
NPI:1447952445
Name:SUNCREST HOME HEALTH CARE, INC
Entity type:Organization
Organization Name:SUNCREST HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO,CFO,SECRETARY,OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VARDAPETYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-812-5227
Mailing Address - Street 1:PO BOX 6841
Mailing Address - Street 2:
Mailing Address - City:PINE MOUNTAIN CLUB
Mailing Address - State:CA
Mailing Address - Zip Code:93222-6841
Mailing Address - Country:US
Mailing Address - Phone:818-812-5227
Mailing Address - Fax:818-945-0987
Practice Address - Street 1:16218 MIL POTRERO HWY UNIT 203 STE B
Practice Address - Street 2:
Practice Address - City:PINE MOUNTAIN CLUB
Practice Address - State:CA
Practice Address - Zip Code:93222
Practice Address - Country:US
Practice Address - Phone:818-812-5227
Practice Address - Fax:818-945-0987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health