Organization Active NPI

Hillside Home Health, Inc

  • Home Health Agency
  • Woodland Hills, CA
National Provider Identifier
1245902840
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
HILLSIDE HOME HEALTH, INC
Practice address
20969 Ventura Blvd Ste 213
Woodland Hills, CA 91364-6619
Phone
(818) 813-8905
Fax
(213) 260-8639
NPI assigned
Oct 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Authorized official

Name
Anzhelika Manukyan
Title
Ceo
Phone
(818) 813-8905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

20969 Ventura Blvd Ste 213
Woodland Hills, CA 91364-6619

Mailing address

20969 Ventura Blvd Ste 213
Woodland Hills, CA 91364-6619
Phone (818) 813-8905

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230417001597 CA Part A Provider - Home Health Agency 1153796594 Practice locations: Woodland Hills, CA

Home health agency certification: CCN 757376

Legal name
HILLSIDE HOME HEALTH, INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 8, 2023
Last certification
Aug 25, 2023
Organization structure
CorporationProprietary
Incorporated
May 24, 2021 in CA
Enrollment address
20969 Ventura Blvd
Ste 213
Woodland Hills, CA 91364-6619

Care Compare: Home health agency

Medicare Care Compare
Listed as
Hillside Home Health, IncCCN 757376
Overall star rating
3 of 5
Ownership
-
Certified
Sep 8, 2023
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

20969 Ventura Blvd
Ste 213
Woodland Hills, CA 91364
Phone (747) 303-9500

Ownership & related parties

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.

NameRoleSinceShare
Srboui Suzy Gouikasian Individual 5% Or Greater Direct Ownership InterestCeo / Boar Member Jun 2, 2021 100%
Corporate OfficerCeo / Boar Member Jun 2, 2021 100%
Corporate DirectorCeo / Boar Member Jun 2, 2021 100%
W-2 Managing EmployeeCeo / Boar Member Jun 2, 2021 100%

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": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1245902840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20969 VENTURA BLVD STE 213",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913646619",
            "telephone_number": "818-813-8905",
            "fax_number": "213-260-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20969 VENTURA BLVD STE 213",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913646619",
            "telephone_number": "818-813-8905",
            "fax_number": "213-260-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSIDE HOME HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "MANUKYAN",
        "authorized_official_first_name": "ANZHELIKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-813-8905"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

Verify at the official NPI Registry.