Avicenna Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

AVICENNA HOME HEALTH, INC.

Practice address

17915 Ventura Blvd Ste 222
Encino, CA 91316-4811

Phone

(323) 559-7915

Fax

(424) 652-5422

NPI assigned

Apr 19, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Harutun Tagaryan

Title

Owner

Phone

(747) 282-1282

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 559574

Legal name

AVICENNA HOME HEALTH, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 5, 2021

Last certification

Nov 5, 2021

Organization structure

CorporationProprietary

Incorporated

Nov 20, 2017 in CA

Enrollment address

17915 Ventura Blvd
Ste 222
Encino, CA 91316-4811

Listed as

Avicenna Home Health, IncCCN 559574

Ownership

-

Certified

Nov 5, 2021

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1245727783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17915 VENTURA BLVD STE 222",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164811",
            "telephone_number": "323-559-7915",
            "fax_number": "424-652-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17915 VENTURA BLVD STE 222",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164811",
            "telephone_number": "323-559-7915",
            "fax_number": "424-652-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVICENNA HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-19",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "TAGARYAN",
        "authorized_official_first_name": "HARUTUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "747-282-1282",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Encino, CA
• Providers in Encino, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.