Organization Active NPI

Da Home Health Care, Inc.

  • Community Based Hospice Care Agency
  • Van Nuys, CA
National Provider Identifier
1063019727
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
DA HOME HEALTH CARE, INC.
Practice address
14545 Friar St Ste 313
Van Nuys, CA 91411-2397
Phone
(818) 616-4354
NPI assigned
Oct 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Authorized official

Name
Ani Hovhannisyan
Title
Ceo
Phone
(818) 616-4354

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

14545 Friar St Ste 313
Van Nuys, CA 91411-2397

Mailing address

14545 Friar St Ste 313
Van Nuys, CA 91411-2397
Phone (818) 616-4354

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210812000080 CA Part A Provider - Home Health Agency 8628472735 Practice locations: Granada Hills, CA

Home health agency certification: CCN 559660

Legal name
DA HOME HEALTH CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 16, 2021
Last certification
Nov 16, 2021
Organization structure
CorporationProprietary
Enrollment address
17541 Chatsworth St
Ste 105
Granada Hills, CA 91344-5720

Care Compare: Home health agency

Medicare Care Compare
Listed as
Da Home Health Care, Inc.CCN 559660
Overall star rating
4 of 5
Ownership
-
Certified
Nov 16, 2021
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2287665Da Home Health Care Inc14545 Friar St Ste 313, Van Nuys, CA 91411Certificate of waiverAug 15, 2027

National Provider Directory

National Provider Directory

Locations

17541 Chatsworth St
Ste 105
Granada Hills, CA 91344
Phone (818) 616-4354

14545 Friar St
Ste 313
Van Nuys, CA 91411
Phone (818) 616-4354

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Ani Hovhannisyan Individual 5% Or Greater Direct Ownership InterestOwner Sep 18, 2020 100%
Corporate OfficerCeo Sep 18, 2020 100%
Corporate DirectorCeo Sep 18, 2020 100%
W-2 Managing EmployeeCeo Sep 18, 2020 100%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1601942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1063019727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14545 FRIAR ST STE 313",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112397",
            "telephone_number": "818-616-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14545 FRIAR ST STE 313",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112397",
            "telephone_number": "818-616-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DA HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-06",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "HOVHANNISYAN",
        "authorized_official_first_name": "ANI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-616-4354"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "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.