Organization Active NPI

Samsara Home Health Care, Inc.

  • Home Health Agency
  • Simi Valley, CA
National Provider Identifier
1205453727
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SAMSARA HOME HEALTH CARE, INC.
Practice address
4225 Valley Fair St
Simi Valley, CA 93063-2952
Phone
(805) 292-0355
Fax
(805) 285-2525
NPI assigned
Jun 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Authorized official

Name
Kristine Santrosyan
Title
Cfo
Phone
(805) 292-0355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4225 Valley Fair St
Simi Valley, CA 93063-2952

Mailing address

4225 Valley Fair St
Simi Valley, CA 93063-2952
Phone (805) 292-0355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210423000290 CA Part A Provider - Home Health Agency 3173931524 Practice locations: Simi Valley, CA

Home health agency certification: CCN 753107

Legal name
SAMSARA HOME HEALTH CARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 11, 2022
Last certification
Feb 11, 2022
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 10, 2020 in CA
Enrollment address
4225 Valley Fair St
Ste 207B
Simi Valley, CA 93063-2955

Care Compare: Home health agency

Medicare Care Compare
Listed as
Samsara Home Health Care IncCCN 753107
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Feb 11, 2022
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
05D2203153Samsara Home Health Care, Inc4225 Valley Fair Street Suite 207B, Simi Valley, CA 93063Certificate of waiverDec 1, 2026

National Provider Directory

National Provider Directory

Locations

4225 Valley Fair St
Ste 207B
Simi Valley, CA 93063
Phone (805) 292-0355

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Mariam Danielyan Individual 5% Or Greater Direct Ownership Interest Jun 10, 2020 33.4%
Corporate OfficerBoard Secretary Jun 10, 2020 33.4%
Corporate DirectorBoard Secretary Jun 10, 2020 33.4%
W-2 Managing EmployeeBoard Secretary Jun 10, 2020 33.4%
Operational/Managerial ControlBoard Secretary Jun 10, 2020 33.4%
Natalya Danelyan Individual 5% Or Greater Direct Ownership Interest Jun 10, 2020 33.3%
Corporate OfficerCeo/Administrator Jun 10, 2020 33.3%
Corporate DirectorCeo/Administrator Jun 10, 2020 33.3%
Operational/Managerial ControlCeo/Administrator Jun 10, 2020 33.3%
Kristine Santrosyan Individual 5% Or Greater Direct Ownership Interest Jun 10, 2020 33.3%
Corporate OfficerCfo Jun 10, 2020 33.3%
Corporate DirectorCfo Jun 10, 2020 33.3%
Operational/Managerial ControlCfo Jun 10, 2020 33.3%
Anzhelika Manukyan Individual Operational/Managerial ControlDon/Administrator Oct 1, 2023

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1205453727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 VALLEY FAIR ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930632952",
            "telephone_number": "805-292-0355",
            "fax_number": "805-285-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 VALLEY FAIR ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930632952",
            "telephone_number": "805-292-0355",
            "fax_number": "805-285-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMSARA HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "SANTROSYAN",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "805-292-0355"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.