Edgewood Home Health Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

EDGEWOOD HOME HEALTH CARE INC

Practice address

7324 Sepulveda Blvd Ste 170
Van Nuys, CA 91405-5033

Phone

(747) 219-0990

Fax

(747) 219-0985

NPI assigned

Feb 24, 2022

Organization subpart

No

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

Authorized official

Name

Gayane Avetisyan

Title

Ceo

Phone

(747) 219-0990

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 758038

Legal name

EDGEWOOD HOME HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 10, 2025

Last certification

May 22, 2025

Organization structure

CorporationProprietary

Enrollment address

7324 Sepulveda Blvd
Ste 170
Van Nuys, CA 91405-5033

Listed as

Edgewood Home Health Care IncCCN 758038

Ownership

-

Certified

Jun 10, 2025

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

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

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1083360424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7324 SEPULVEDA BLVD STE 170",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914055033",
            "telephone_number": "747-219-0990",
            "fax_number": "747-219-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7324 SEPULVEDA BLVD STE 170",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914055033",
            "telephone_number": "747-219-0990",
            "fax_number": "747-219-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "AVETISYAN",
        "authorized_official_first_name": "GAYANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-219-0990"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.