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Organization
SOURCE OF LIFE HOME CARE
Active
Organization
SOURCE OF LIFE HOME CARE
Active
Other names
Source of Life Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
TIGRAN HAKOBYAN (PRESIDENT/CEO)
(661) 425-7162
Entity
Organization
Contact information
Practice address
23560 LYONS AVE STE 205, NEWHALL, CA 91321-5721
(661) 425-7162
Mailing address
23560 LYONS AVE STE 205, NEWHALL, CA 91321-5721
(661) 425-7162
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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