NPIMap

Organization Active NPI

Valde Home Health, Inc

  • Home Health Agency
  • Victorville, CA
National Provider Identifier
1184073389
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
VALDE HOME HEALTH, INC
Practice address
12241 Industrial Blvd
Suite 202
Victorville, CA 92395-7794
Phone
(818) 472-7320
NPI assigned
Jun 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Authorized official

Name
Mr. Garnik Gevorgyan
Title
Ceo
Phone
(818) 472-7320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

12241 Industrial Blvd
Suite 202
Victorville, CA 92395-7794

Mailing address

12241 Industrial Blvd
Suite 202
Victorville, CA 92395-7794
Phone (818) 472-7320

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161111000040 CA Part A Provider - Home Health Agency 8325327554 Practice locations: Victorville, CA

Home health agency certification: CCN 053161

Legal name
VALDE HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 9, 2018
Last certification
Jun 9, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
12241 Industrial Blvd
Ste 202
Victorville, CA 92395-8301

Care Compare: Home health agency

Medicare Care Compare
Listed as
Valde Home Health, IncCCN 053161
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Jun 9, 2018
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
05D2147793Valde Home Health Inc12241 Industrial Blvd. Suite 202, Victorville, CA 92395Certificate of waiverApr 25, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jacqueline Robinson Individual W-2 Managing EmployeeAdministrator Designee/DPCS Designe Nov 1, 2021
Garnik Gevorgyan Individual 5% Or Greater Direct Ownership InterestOwner May 2, 2016 100%
Corporate OfficerCeo/Cfo/Secretary/Chairman of TH May 2, 2016 100%
Corporate DirectorCeo/Cfo/Secretary/Chairman of TH May 2, 2016 100%
W-2 Managing EmployeeCeo/Cfo/Secretary/Chairman of TH May 2, 2016 100%
Omanize Rodriguez Individual W-2 Managing EmployeeOffice Manager, Care Coordinator Oct 11, 2021
Bipinchandra V Bhagat Individual Contracted Managing EmployeeMD; May 1, 2026
Karen a Plank Individual W-2 Managing EmployeeAd;DPCS Nov 1, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 30

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1184073389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12241 INDUSTRIAL BLVD",
            "address_2": "SUITE 202",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957794",
            "telephone_number": "818-472-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12241 INDUSTRIAL BLVD",
            "address_2": "SUITE 202",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957794",
            "telephone_number": "818-472-7320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALDE HOME HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "GEVORGYAN",
        "authorized_official_first_name": "GARNIK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-472-7320",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.