Organization Active NPI

Cupid Home Health, Inc.

  • Home Health Agency
  • Van Nuys, CA
National Provider Identifier
1023769221
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CUPID HOME HEALTH, INC.
Practice address
14531 Hamlin St Ste 170
Van Nuys, CA 91411-1627
Phone
(747) 217-1236
NPI assigned
Jan 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hristo Stefanov Ivanov
Title
Ceo
Phone
(747) 217-1236

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

14531 Hamlin St Ste 170
Van Nuys, CA 91411-1627

Mailing address

14531 Hamlin St Ste 170
Van Nuys, CA 91411-1627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230612001084 CA Part A Provider - Home Health Agency 3678947199 Practice locations: Encino, CA

Home health agency certification: CCN 757744

Legal name
CUPID HOME HEALTH, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 20, 2024
Last certification
Jul 18, 2024
Organization structure
CorporationProprietary
Enrollment address
16200 Ventura Blvd
Ste 202a
Encino, CA 91436-2215

Care Compare: Home health agency

Medicare Care Compare
Listed as
Cupid Home Health, Inc.CCN 757744
Ownership
-
Certified
Aug 20, 2024
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

16200 Ventura Blvd
Ste 202A
Encino, CA 91436
Phone (747) 221-7123

14531 Hamlin St
Ste 170
Van Nuys, CA 91411
Phone (747) 217-1236

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Hakeem Fahm Individual 5% Or Greater Direct Ownership Interest Mar 31, 2025 40%
Corporate OfficerCeo, Cfo Mar 31, 2025 40%
Cupid Group, Inc. Organization, Van Nuys, CA Created for acquisition, Corporation 5% Or Greater Direct Ownership Interest Dec 1, 2021 100%
Chikaodi Happiness Fahm Individual Corporate OfficerSecretary Mar 31, 2025
W-2 Managing EmployeeAd; Mar 31, 2025
Hristo Stefanov Ivanov Individual 5% Or Greater Direct Ownership Interest Mar 31, 2025 60%
Corporate OfficerCeo/Cfo/Secretary Dec 1, 2021 100%
Corporate DirectorCeo/Cfo/Secretary Dec 1, 2021 100%
W-2 Managing EmployeeCeo/Cfo/Secretary Dec 1, 2021 100%

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1023769221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14531 HAMLIN ST STE 170",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14531 HAMLIN ST STE 170",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111627",
            "telephone_number": "747-217-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUPID HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "IVANOV",
        "authorized_official_first_name": "HRISTO",
        "authorized_official_middle_name": "STEFANOV",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-217-1236"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.