Organization Active NPI

Lakeview Home Health Care

  • Home Health Agency
  • Chatsworth, CA
National Provider Identifier
1124603881
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LAKEVIEW HOME HEALTH CARE
Practice address
21405 Devonshire St Ste 206
Chatsworth, CA 91311-2939
Phone
(818) 726-8447
NPI assigned
Mar 15, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Authorized official

Name
Sarkis Gezalyan
Title
Ceo
Phone
(818) 726-8447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

21405 Devonshire St Ste 206
Chatsworth, CA 91311-2939

Mailing address

21405 Devonshire St Ste 206
Chatsworth, CA 91311-2939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220628001538 CA Part A Provider - Home Health Agency 0941689582 Practice locations: Chatsworth, CA

Home health agency certification: CCN 757302

Legal name
LAKEVIEW HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 28, 2023
Last certification
Apr 14, 2023
Organization structure
CorporationProprietary
Incorporated
Feb 17, 2021 in CA
Enrollment address
21405 Devonshire St
Ste 206
Chatsworth, CA 91311-2939

Care Compare: Home health agency

Medicare Care Compare
Listed as
Lakeview Home Health CareCCN 757302
Overall star rating
3 of 5
Ownership
-
Certified
Apr 28, 2023
Medicare certification status
ActiveFrom the Provider of Services file

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
05D2290271Lakeview Home Health Care21405 Devonshire Street, Suite 206, Chatsworth, CA 91311Certificate of waiverSep 21, 2027

National Provider Directory

National Provider Directory

Locations

21405 Devonshire St
Ste 206
Chatsworth, CA 91311
Phone (747) 202-3579

Ownership & related parties

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.

NameRoleSinceShare
Sarkis Gezlyan Individual 5% Or Greater Direct Ownership InterestCeo Feb 17, 2021 100%
Corporate OfficerCeo Feb 17, 2021 100%
Corporate DirectorCeo Feb 17, 2021 100%
Verzhine Fodolyan Individual W-2 Managing EmployeeAdministrative/DPCS Mar 19, 2021 100%
Operational/Managerial ControlAdministrative/DPCS Mar 19, 2021 100%

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": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1124603881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21405 DEVONSHIRE ST STE 206",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21405 DEVONSHIRE ST STE 206",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112939",
            "telephone_number": "818-726-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW HOME HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "GEZALYAN",
        "authorized_official_first_name": "SARKIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-726-8447"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatsworth, CA

Sources for this page

Verify at the official NPI Registry.