Organization Active NPI

Marys Home Health Care, Inc

  • Home Health Agency
  • Glendale, CA
National Provider Identifier
1093391294
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MARYS HOME HEALTH CARE, INC
Practice address
127 S Brand Blvd Ste 210
Glendale, CA 91204-1372
Phone
(747) 737-3028
NPI assigned
Mar 19, 2021
Last updated
Mar 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Authorized official

Name
Mary Teradamyan
Title
Ceo
Phone
(747) 737-3028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

127 S Brand Blvd Ste 210
Glendale, CA 91204-1372

Mailing address

127 S Brand Blvd Ste 210
Glendale, CA 91204-1372
Phone (747) 737-3028

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230925002392 CA Part A Provider - Home Health Agency 8921452913 Practice locations: Glendale, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093391294. Details of each certification follow.

Home health agency certification: CCN 757698

Legal name
MARYS HOME HEALTH CARE, INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 12, 2024
Last certification
Jul 12, 2024
Organization structure
CorporationProprietary
Incorporated
Feb 22, 2021 in CA
Enrollment address
127 S Brand Blvd
Ste 210
Glendale, CA 91204-1372

Care Compare: Home health agency

Medicare Care Compare
Listed as
Mary's Home Health Care, Inc.CCN 757698 · All quality measures
Ownership
-
Certified
Jul 12, 2024
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

127 S Brand Blvd
Ste 210
Glendale, CA 91204
Phone (747) 737-3028

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
Mary M Teradamyan Individual 5% Or Greater Direct Ownership InterestCeo Feb 22, 2021 100%
Corporate OfficerCeo Feb 22, 2021 100%
Corporate DirectorCeo Feb 22, 2021 100%
W-2 Managing EmployeeCeo Feb 22, 2021

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": "1616112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616112000000",
    "number": "1093391294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 S BRAND BLVD STE 210",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041372",
            "telephone_number": "747-737-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S BRAND BLVD STE 210",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041372",
            "telephone_number": "747-737-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYS HOME HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A",
        "authorized_official_last_name": "TERADAMYAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-737-3028"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.