Organization Active NPI

Boost Home Health, Inc.

  • Home Health Agency
  • Reseda, CA
National Provider Identifier
1114519733
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
BOOST HOME HEALTH, INC.
Practice address
18747 Sherman Way Ste 210
Reseda, CA 91335-4000
Phone
(818) 851-1052
NPI assigned
Feb 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Authorized official

Name
Shushanik Grigoryan
Title
Ceo
Phone
(818) 851-1052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

18747 Sherman Way Ste 210
Reseda, CA 91335-4000

Mailing address

18747 Sherman Way Ste 210
Reseda, CA 91335-4000
Phone (818) 851-1052

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210309003291 CA Part A Provider - Home Health Agency 3072929454 Practice locations: Reseda, CA

Home health agency certification: CCN 757060

Legal name
BOOST HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 23, 2022
Last certification
Aug 17, 2022
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jan 12, 2021 in CA
Enrollment address
18747 Sherman Way
Ste 210
Reseda, CA 91335-4000

Care Compare: Home health agency

Medicare Care Compare
Listed as
Boost Home Health, Inc.CCN 757060 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Aug 23, 2022
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

18747 Sherman Way
Ste 210
Reseda, CA 91335
Phone (818) 851-1052

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
Shushanik Grigoryan Individual 5% Or Greater Direct Ownership Interest Jan 12, 2021 100%
Corporate Officer Jan 12, 2021 100%
Corporate Director Jan 12, 2021 100%
W-2 Managing Employee Jan 12, 2021 100%

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1114519733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18747 SHERMAN WAY STE 210",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354000",
            "telephone_number": "818-851-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18747 SHERMAN WAY STE 210",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354000",
            "telephone_number": "818-851-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOST HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "GRIGORYAN",
        "authorized_official_first_name": "SHUSHANIK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-851-1052"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reseda, CA

Sources for this page

Verify at the official NPI Registry.