Organization Active NPI

A&K Home Health, Inc.

  • Home Health Agency
  • Glendale, CA
National Provider Identifier
1154885671
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
A&K HOME HEALTH, INC.
Practice address
225 W Broadway Ste 115
Glendale, CA 91204-5108
Phone
(818) 696-6010
NPI assigned
Jan 29, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Authorized official

Name
Anna Petrosyan
Title
Ceo
Phone
(818) 696-6010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

225 W Broadway Ste 115
Glendale, CA 91204-5108

Mailing address

225 W Broadway Ste 115
Glendale, CA 91204-5108

Other identifiers 1

IdentifierTypeStateIssuer
1MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200303001862 CA Part A Provider - Home Health Agency 2163859190 Practice locations: Glendale, CA

Home health agency certification: CCN 559230

Legal name
A&K HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 22, 2020
Last certification
Apr 22, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
225 W Broadway
Ste 115
Glendale, CA 91204-5108

Care Compare: Home health agency

Medicare Care Compare
Listed as
A&K Home Health, IncCCN 559230
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Apr 22, 2020
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
05D2188506A&K Home Health, Inc225 W Broadway Ste 115, Glendale, CA 91204Certificate of waiverJul 16, 2026

National Provider Directory

National Provider Directory

Locations

225 W Broadway
Ste 115
Glendale, CA 91204
Phone (818) 696-6010

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.

NameRoleSinceShare
Anna Petrosyan Individual 5% Or Greater Direct Ownership InterestCeo Dec 3, 2018 100%
Corporate OfficerCeo Nov 8, 2019 100%
Corporate DirectorCeo Nov 18, 2019 100%
W-2 Managing EmployeeCeo Nov 8, 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": "1548720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548720000000",
    "number": "1154885671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W BROADWAY STE 115",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912045108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W BROADWAY STE 115",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912045108",
            "telephone_number": "818-696-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A&K HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-01-29",
        "status": "A",
        "authorized_official_last_name": "PETROSYAN",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-696-6010"
    },
    "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

Verify at the official NPI Registry.