Organization Active NPI

Red Rose Home Health

  • Home Health Agency
  • Burbank, CA
National Provider Identifier
1174296222
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
RED ROSE HOME HEALTH
Practice address
3721 W Burbank Blvd Ste C2
Burbank, CA 91505-2240
Phone
(747) 336-3085
Fax
(747) 336-3081
NPI assigned
Jul 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Authorized official

Name
Arik Grigoryan
Title
Ceo
Phone
(747) 336-3085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3721 W Burbank Blvd Ste C2
Burbank, CA 91505-2240

Mailing address

3721 W Burbank Blvd Ste C2
Burbank, CA 91505-2240
Phone (747) 336-3085

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230504000484 CA Part A Provider - Home Health Agency 5890150478 Practice locations: Burbank, CA

Home health agency certification: CCN 757537

Legal name
RED ROSE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 9, 2024
Last certification
Feb 9, 2024
Organization structure
CorporationProprietary
Incorporated
Jul 15, 2021 in CA
Enrollment address
3721 W Burbank Blvd
Ste C2
Burbank, CA 91505-2240

Care Compare: Home health agency

Medicare Care Compare
Listed as
Red Rose Home HealthCCN 757537
Overall star rating
2.5 of 5
Ownership
-
Certified
Feb 9, 2024
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

3721 W Burbank Blvd
Ste C2
Burbank, CA 91505
Phone (747) 336-3085

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
Arik Grigoryan Individual 5% Or Greater Direct Ownership InterestCeo Jul 15, 2021 100%
Corporate OfficerCeo Jul 15, 2021 100%
Corporate DirectorCeo Jul 15, 2021 100%
W-2 Managing EmployeeCeo Jul 15, 2021 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": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1174296222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 W BURBANK BLVD STE C2",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052240",
            "telephone_number": "747-336-3085",
            "fax_number": "747-336-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 W BURBANK BLVD STE C2",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052240",
            "telephone_number": "747-336-3085",
            "fax_number": "747-336-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED ROSE HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "GRIGORYAN",
        "authorized_official_first_name": "ARIK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-336-3085"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.