Great Grace Home Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GREAT GRACE HOME INC

Practice address

401 N Brand Blvd Ste 834
Glendale, CA 91203-4451

Phone

(818) 480-4829

Fax

(877) 426-0187

NPI assigned

Dec 8, 2021

Last updated

Dec 8, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Artur Gazaryan

Title

Ceo

Phone

(818) 480-4829

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144989096. Details of each certification follow.

• CCN 757629 Home health agency · Active · Details

Home health agency certification: CCN 757629

Legal name

GREAT GRACE HOME INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 26, 2024

Last certification

Apr 23, 2024

Organization structure

CorporationProprietary

Enrollment address

401 N Brand Blvd
Ste 834
Glendale, CA 91203-4451

Listed as

Great Grace Home IncCCN 757629 · All quality measures

Overall star rating

3.5 of 5

Ownership

-

Certified

Apr 26, 2024

Medicare certification status

ActiveFrom the Provider of Services file

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.

Affiliated clinicians 2

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

• Rosan Mendoza Derayunan, FNP-BC

  • Family Nurse Practitioner
  • Simi Valley, CA
  • NPI 1740942481

  Home health agency

  Care Compare affiliation
• Meera Sohail, M.D

  • Internal Medicine Physician
  • Westminster, CA
  • NPI 1982881645

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1144989096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N BRAND BLVD STE 834",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034451",
            "telephone_number": "818-480-4829",
            "fax_number": "877-426-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N BRAND BLVD STE 834",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034451",
            "telephone_number": "818-480-4829",
            "fax_number": "877-426-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT GRACE HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "GAZARYAN",
        "authorized_official_first_name": "ARTUR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-480-4829"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quinette Gray
• Nicci Michele Grayson, M.S. CCC-SLP
• Graziani Chiropractic, Inc
• Great American Hospice Care
• Great Care Hospice and Palliative Care, Inc.
• Great Life Home Health Care Inc.
• Kathy Greathouse, LMFT
• Greatness Hospice, Inc.
• Greatway Therapy LLC
• Green Life Hospice Inc

• Home Health Agency in Glendale, CA
• Providers in Glendale, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.