La Home Health Agency

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LA HOME HEALTH AGENCY

Practice address

21133 Victory Blvd Ste 215
Canoga Park, CA 91303-4006

Phone

(310) 562-7382

NPI assigned

Apr 14, 2019

Organization subpart

No

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

Authorized official

Name

Alexander Lyubenkov

Title

Ceo/Admin

Phone

(818) 434-1921

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 559532

Legal name

LA HOME HEALTH AGENCY

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 1, 2021

Last certification

Jun 1, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Feb 4, 2019 in CA

Enrollment address

21133 Victory Blvd
Ste 215
Canoga Park, CA 91303-4006

Listed as

La Home Health AgencyCCN 559532

Overall star rating

5 of 5

Ownership

Proprietary

Certified

Jun 1, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

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.

Affiliated clinicians 1

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

• Ali Hadadz, MD

  • General Practice Physician
  • Marina del Rey, CA
  • NPI 1316970866

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555200000000",
    "number": "1245893486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21801 BURBANK BLVD UNIT 68",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913676415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21133 VICTORY BLVD STE 215",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913034006",
            "telephone_number": "310-562-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA HOME HEALTH AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-14",
        "last_updated": "2019-04-14",
        "status": "A",
        "authorized_official_last_name": "LYUBENKOV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CEO/ADMIN",
        "authorized_official_telephone_number": "818-434-1921"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steve Kudler, PSY.D, FPPR
• Ai Kusayanagi
• Alexis Rae Kusnier, M.S., CCC-SLP
• Hannah Kwon
• Kwadwo Kyei
• La Wellness Spa Center Inc.
• Michelle Labruzzi, MA, BCBA
• Alecsandra Lacsamana
• Ziba Laed, RPH
• Karla Flores Lagunas, LCSW

• Home Health Agency in Canoga Park, CA
• Providers in Canoga Park, 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 Apr 14, 2019; 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.