Organization Active NPI

Angels Care Home Health Agency

  • Home Health Agency
  • Fresno, CA
National Provider Identifier
1235897877
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ANGELS CARE HOME HEALTH AGENCY
Practice address
125 E Barstow Ave Ste 113
Fresno, CA 93710-5023
Phone
(559) 355-6932
Fax
(559) 449-9644
NPI assigned
Dec 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Authorized official

Name
Mrs. Ripsime Lily Gouff
Title
Secretary
Phone
(559) 355-6932

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Community Based Hospice Care Agency 251G00000X

Addresses

Primary practice location

125 E Barstow Ave Ste 113
Fresno, CA 93710-5023

Mailing address

125 E Barstow Ave Ste 113
Fresno, CA 93710-5023
Phone (559) 293-4975

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL angelscarehomehealth.inc@gmail.com
CONNECT URL email
Other URL https://mail.google.com/mail/u/1/#inbox

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220325000064 CA Part A Provider - Home Health Agency 2062807225 Practice locations: Fresno, CA

Home health agency certification: CCN 757609

Legal name
ANGELS CARE HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 5, 2024
Last certification
Apr 5, 2024
Organization structure
CorporationProprietary
Incorporated
Jun 5, 2021 in CA
Enrollment address
125 E Barstow Ave
Ste 113
Fresno, CA 93710-5023

Care Compare: Home health agency

Medicare Care Compare
Listed as
Angels Care Home Health AgencyCCN 757609
Ownership
-
Certified
Apr 5, 2024
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

125 E Barstow Ave
Ste 113
Fresno, CA 93710
Phone (559) 293-4975

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Ambartsum Harry Semirjyan Individual 5% Or Greater Direct Ownership Interest Jun 5, 2021 50%
Corporate OfficerCeo Jun 5, 2021 50%
Corporate DirectorCeo Jun 5, 2021 50%
Operational/Managerial ControlCeo Jun 5, 2021 50%
Ripsime Gouff Individual 5% Or Greater Direct Ownership Interest Jun 5, 2021 50%
Corporate OfficerCfo, Secretary Jun 5, 2021 50%
Corporate DirectorCfo, Secretary Jun 5, 2021 50%
W-2 Managing EmployeeCfo, Secretary Jun 5, 2021 50%
Operational/Managerial ControlCfo, Secretary Jun 5, 2021 50%

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": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1235897877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E BARSTOW AVE STE 113",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105023",
            "telephone_number": "559-293-4975",
            "fax_number": "559-293-4976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BARSTOW AVE STE 113",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105023",
            "telephone_number": "559-355-6932",
            "fax_number": "559-449-9644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELS CARE HOME HEALTH AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "GOUFF",
        "authorized_official_first_name": "RIPSIME",
        "authorized_official_middle_name": "LILY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "559-355-6932",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "angelscarehomehealth.inc@gmail.com",
            "affiliation": "N",
            "address_1": "125 E Barstow Ave Ste 113",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937105023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "email",
            "affiliation": "N",
            "address_1": "125 E Barstow Ave Ste 113",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937105023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://mail.google.com/mail/u/1/#inbox",
            "affiliation": "N",
            "address_1": "125 E Barstow Ave Ste 113",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937105023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.