Divine Providence Home Health Care

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DIVINE PROVIDENCE HOME HEALTH CARE

Practice address

22151 Ventura Blvd Ste 200a
Woodland Hills, CA 91364-1666

Phone

(747) 800-3815

Fax

(747) 800-3814

NPI assigned

Dec 17, 2021

Organization subpart

No

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

Authorized official

Name

Narine Daldumyan

Title

Ceo

Phone

(747) 800-3815

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757612

Legal name

DIVINE PROVIDENCE HOME HEALTH CARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 6, 2024

Last certification

Mar 6, 2024

Organization structure

CorporationProprietary

Incorporated

Oct 21, 2021 in CA

Enrollment address

22151 Ventura Blvd
Ste 200a
Woodland Hills, CA 91364-1666

Listed as

Divine Providence Home Health CareCCN 757612

Ownership

-

Certified

Mar 6, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1144989161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22151 VENTURA BLVD STE 200A",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641666",
            "telephone_number": "747-800-3815",
            "fax_number": "747-800-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22151 VENTURA BLVD STE 200A",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641666",
            "telephone_number": "747-800-3815",
            "fax_number": "747-800-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PROVIDENCE HOME HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "DALDUMYAN",
        "authorized_official_first_name": "NARINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-800-3815"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Woodland Hills, CA
• Providers in Woodland Hills, 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 17, 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.