Celebrity Homehealth, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

APPLIED FOR Issued in AZ

Legal business name

CELEBRITY HOMEHEALTH, INC.

Practice address

2510 S Rural Rd Ste 102
Tempe, AZ 85282-2497

Phone

(480) 966-8888

Fax

(480) 966-8892

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

David Bustan, ACCOUNTANT

Title

Ceo, Pres.

Phone

(818) 492-1700

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 3

• CELEBRITY HOSPICE Doing business as
• Celebrity HomeHealth Doing business as
• Celebrity HomeHealth & Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Home health agency certification: CCN 037257

Legal name

CELEBRITY HOMEHEALTH INC.

Doing business as

CELEBRITY HOMEHEALTH & HOSPICE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 27, 2008

Last certification

Aug 15, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Apr 29, 2005 in AZ

Enrollment address

2510 S Rural Rd
Ste 102
Tempe, AZ 85282-2497

Listed as

Celebrity Home Health & HospiceCCN 037257

Ownership

Proprietary

Certified

Aug 27, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Listed as

Celebrity Home Health & HospiceCCN 031640

Ownership

For-Profit

Certified

May 4, 2015

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

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": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1083836183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14950 VENTURA BLVD",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033455",
            "telephone_number": "818-343-4001",
            "fax_number": "818-996-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 S RURAL RD STE 102",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822497",
            "telephone_number": "480-966-8888",
            "fax_number": "480-966-8892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14950 Ventura Blvd",
            "address_purpose": "LOCATION",
            "city": "Sherman Oaks",
            "state": "CA",
            "postal_code": "914033455",
            "country_code": "US",
            "telephone_number": "818-343-4001 x1700",
            "fax_number": "818-996-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CELEBRITY HOMEHEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "BUSTAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO, PRES.",
        "authorized_official_telephone_number": "818-492-1700",
        "authorized_official_credential": "ACCOUNTANT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "APPLIED FOR",
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AZ",
            "license": "HSPC6509",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HACCCS",
            "identifier": "426407",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA55555F",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CELEBRITY HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Celebrity HomeHealth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Celebrity HomeHealth & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.