Extensive Home Health Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

EXTENSIVE HOME HEALTH CARE INC

Practice address

9602 Las Tunas Dr Ste 201
Temple City, CA 91780-2150

Phone

(626) 631-2011

Fax

(626) 631-2012

NPI assigned

Sep 20, 2021

Organization subpart

No

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

Authorized official

Name

Arthur Godelekyan

Title

Ceo

Phone

(626) 631-2011

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757729

Legal name

EXTENSIVE HOME HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 19, 2024

Last certification

Jul 19, 2024

Organization structure

CorporationProprietary

Enrollment address

9602 Las Tunas Dr
Ste 201
Temple City, CA 91780-2150

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.

Listed as

Extensive Home Health Care IncCCN 757729

Overall star rating

4 of 5

Ownership

-

Certified

Jul 19, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Listed as

Allied Home Health CorpCCN 059528

Ownership

Proprietary

Certified

Nov 21, 2012

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632096000000",
    "number": "1104596170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9602 LAS TUNAS DR STE 201",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917802150",
            "telephone_number": "626-631-2011",
            "fax_number": "626-631-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9602 LAS TUNAS DR STE 201",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917802150",
            "telephone_number": "626-631-2011",
            "fax_number": "626-631-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENSIVE HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A",
        "authorized_official_last_name": "GODELEKYAN",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-631-2011"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Park DMD Inc
• Anthony A Euredjian, DDS
• Evalina Josefsson,DDS, Professional Corporation
• Robin Bryna Evans, RDN
• Evercare Health Center
• Youssef Ghassan Fakhro, PHARMD
• Yi Fen Fan, L.AC
• Xu Jun Feng, PT
• Fishers Drug Store
• Garrett Scott Fong, DMD, MS

• All providers in Temple City, CA
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.