Active NPI
Golden Years Home Health, Inc.
- Home Health Agency
- Arcadia, CA
National Provider Identifier
1154515039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- GOLDEN YEARS HOME HEALTH, INC.
- Practice address
- 107 W. Huntington Drive
#F
Arcadia, CA 91007-3049 - Phone
- (626) 445-2392
- Fax
- (626) 446-2984
- NPI assigned
- Sep 4, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sana Shahin
- Title
- Secretary Administrator
- Phone
- (626) 445-2392
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | CA | Primary |
Addresses
Primary practice location
107 W. Huntington Drive
#F
Arcadia, CA 91007-3049
Mailing address
107 W. Huntington Drive
#F
Arcadia, CA 91007-3049
Phone (626) 445-2392
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121205000000 | CA | Part A Provider - Home Health Agency | 6305932013 | Practice locations: San Dimas, CA |
Home health agency certification: CCN 059592
- Legal name
- GOLDEN YEARS HOME HEALTH, INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Mar 7, 2014
- Last certification
- Oct 4, 2019
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Aug 28, 2007 in CA
- Enrollment address
- 550 W Cienega Ave
Ste H
San Dimas, CA 91773-2977
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Golden Years Home Health, Inc.
- Overall star rating
- Ownership
- Proprietary
- Certified
- Mar 7, 2014
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider DirectoryLocations
107 W Huntington Dr
Ste F
Arcadia, CA 91007
Phone (626) 445-2392
550 W Cienega Ave
Ste H
San Dimas, CA 91773
Phone (626) 445-2392
1305 W Arrow Hwy
Ste 202
San Dimas, CA 91773
Phone (626) 445-2392
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Sahar Fakhouri | 5% Or Greater Direct Ownership Interest | Aug 15, 2019 | 33.33% |
| Corporate Officer | Sep 1, 2019 | 33.33% | |
| Corporate Director | Sep 1, 2019 | 33.33% | |
| Nayri Tomassian | 5% Or Greater Direct Ownership Interest | Aug 15, 2019 | 33.33% |
| Corporate Officer | Sep 1, 2019 | 33.33% | |
| Corporate Director | Sep 1, 2019 | 33.33% | |
| W-2 Managing Employee | Sep 1, 2019 | 33.33% | |
| Sana B Shahin | 5% Or Greater Direct Ownership Interest | Aug 15, 2019 | 33.33% |
| Corporate Officer | Sep 1, 2019 | 33.33% | |
| Corporate Director | Sep 1, 2019 | 33.33% | |
| W-2 Managing Employee | Sep 1, 2019 | 33.33% | |
| Operational/Managerial Control | Sep 1, 2019 | 33.33% |
Practitioners & affiliated clinicians
Affiliated clinicians 6
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": "1188864000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1369872000000",
"number": "1154515039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 W. HUNTINGTON DRIVE",
"address_2": "#F",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910073049",
"telephone_number": "626-445-2392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 W. HUNTINGTON DRIVE",
"address_2": "#F",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910073049",
"telephone_number": "626-445-2392",
"fax_number": "626-446-2984"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOLDEN YEARS HOME HEALTH, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-09-04",
"last_updated": "2013-05-30",
"status": "A",
"authorized_official_last_name": "SHAHIN",
"authorized_official_first_name": "SANA",
"authorized_official_title_or_position": "SECRETARY ADMINISTRATOR",
"authorized_official_telephone_number": "626-445-2392"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcadia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; 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.