NPIMap

Organization Active NPI

Hollywood Health System Inc

  • Home Health Agency
  • North Hollywood, CA
National Provider Identifier
1114996154
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
980001532 Issued in CA
Legal business name
HOLLYWOOD HEALTH SYSTEM INC
Practice address
4640 Lankershim Blvd Ste 100
North Hollywood, CA 91602-1845
Phone
(323) 662-3731
Fax
(323) 662-3751
NPI assigned
Mar 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Authorized official

Name
Grigor Adamyan
Title
Ceo
Phone
(213) 399-7777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 980001532 CA Primary

Addresses

Primary practice location

4640 Lankershim Blvd Ste 100
North Hollywood, CA 91602-1845

Mailing address

4640 Lankershim Blvd Ste 100
North Hollywood, CA 91602-1845
Phone (323) 662-3731

Other names 1

  • Hollywood Home Health Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050429000683 CA Part A Provider - Home Health Agency 6800835711 Practice locations: North Hollywood, CA

Home health agency certification: CCN 058310

Legal name
HOLLYWOOD HEALTH SYSTEM INC
Doing business as
HOLLYWOOD HOME HEALTH SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 17, 2005
Last certification
Jun 11, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 6, 2003 in CA
Enrollment address
4640 Lankershim Blvd
Suite # 100
North Hollywood, CA 91602-9998

Care Compare: Home health agency

Medicare Care Compare
Listed as
Hollywood Home Health ServicesCCN 058310
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Sep 17, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1015135Hollywood Home Health Services4640 Lankershim Blvd Ste 100, North Hollywood, CA 91602Certificate of waiverJul 23, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

4430 Fountain Ave
Ste 1
Los Angeles, CA 90029
Phone (323) 662-3731

4640 Lankershim Blvd
Ste 100
North Hollywood, CA 91602
Phone (323) 662-3731

111 Universal Hollywood Dr
Ste 1770
Universal City, CA 91608
Phone (323) 662-3731

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Rita R Lapaz Individual W-2 Managing EmployeeDir of Patient Care SVCS/ Adminr Sep 22, 2014 50%
Siranush Manukyan Individual 5% Or Greater Direct Ownership Interest Mar 15, 2006 50%
Corporate OfficerCeo Mar 15, 2006 25%
Grigor Adamyan Individual 5% Or Greater Direct Ownership Interest Mar 15, 2006 50%
Corporate OfficerCfo Mar 15, 2006 25%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hollywood HospiceNorth Hollywood, CA, CCN 551787 Hospice 5% Or Greater Direct Ownership Interest (100%) Oct 15, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 35

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1114996154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 LANKERSHIM BLVD STE 100",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916021845",
            "telephone_number": "323-662-3731",
            "fax_number": "323-662-3751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 LANKERSHIM BLVD STE 100",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916021845",
            "telephone_number": "323-662-3731",
            "fax_number": "323-662-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLYWOOD HEALTH SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "ADAMYAN",
        "authorized_official_first_name": "GRIGOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-399-7777"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hollywood Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hollywood Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.