Active NPI
Vitality Home Health Care, Inc.
- Home Health Agency
- Glendale, CA
National Provider Identifier
1154882850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- VITALITY HOME HEALTH CARE, INC.
- Practice address
- 427 W Colorado St Ste 105
Glendale, CA 91204-3044 - Phone
- (747) 240-6949
- NPI assigned
- Mar 26, 2019
- 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
- Erna Balasanian
- Title
- Ceo
- Phone
- (747) 240-6949
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
427 W Colorado St Ste 105
Glendale, CA 91204-3044
Mailing address
427 W Colorado St Ste 105
Glendale, CA 91204-3044
Phone (747) 240-6949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200527000655 | CA | Part A Provider - Home Health Agency | 4486075645 | Practice locations: Glendale, CA |
Home health agency certification: CCN 559296
- Legal name
- VITALITY HOME HEALTH CARE INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jul 21, 2020
- Last certification
- Jul 21, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Jan 25, 2019 in CA
- Enrollment address
- 427 W Colorado St
Ste 105
Glendale, CA 91204-3044
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Vitality Home Health Care, Inc
- Ownership
- Proprietary
- Certified
- Jul 21, 2020
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider DirectoryLocations
427 W Colorado St
Ste 105
Glendale, CA 91204
Phone (747) 240-6949
Ownership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Erna Balasanian | 5% Or Greater Direct Ownership Interest | Jan 25, 2019 | 100% |
| Corporate Officer | Jan 25, 2019 | 100% | |
| Corporate Director | Jan 25, 2019 | 100% | |
| W-2 Managing Employee | Jan 25, 2019 | 100% | |
| Operational/Managerial Control | Jan 25, 2019 | 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": "1553558400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1553558400000",
"number": "1154882850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "427 W COLORADO ST STE 105",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912043044",
"telephone_number": "747-240-6949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "427 W COLORADO ST STE 105",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912043044",
"telephone_number": "747-240-6949"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VITALITY HOME HEALTH CARE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2019-03-26",
"last_updated": "2019-03-26",
"status": "A",
"authorized_official_last_name": "BALASANIAN",
"authorized_official_first_name": "ERNA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "747-240-6949"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.