Organization Active NPI

Lakewood Home Health & Palliative Care Inc

  • Home Health Agency
  • Burbank, CA
National Provider Identifier
1255779187
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LAKEWOOD HOME HEALTH & PALLIATIVE CARE INC
Practice address
539 N Glenoaks Blvd
Suite 301F
Burbank, CA 91502-3201
Phone
(747) 241-8400
Fax
(747) 241-8401
NPI assigned
Jun 13, 2013
Last updated
May 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Authorized official

Name
Mr. Armen Jrbashyan
Title
Ceo
Phone
(747) 241-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

539 N Glenoaks Blvd
Suite 301F
Burbank, CA 91502-3201

Mailing address

539 N Glenoaks Blvd
Suite 301F
Burbank, CA 91502-3201
Phone (747) 241-8400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160929001284 CA Part A Provider - Home Health Agency 0941437222 Practice locations: Burbank, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255779187. Details of each certification follow.

Home health agency certification: CCN 053157

Legal name
LAKEWOOD HOME HEALTH & PALLIATIVE CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 9, 2018
Last certification
Feb 9, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 26, 2013 in CA
Enrollment address
539 N Glenoaks Blvd
Ste 301F
Burbank, CA 91502-3209

Care Compare: Home health agency

Medicare Care Compare
Listed as
Lakewood Home Health & Palliative Care IncCCN 053157 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Feb 9, 2018
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
05D2115995Lakewood Home Health & Palliative Care, Inc.539 N Glenoaks Blvd Ste 301F, Burbank, CA 91502Certificate of waiverJul 17, 2028

National Provider Directory

National Provider Directory

Locations

539 N Glenoaks Blvd
Ste 301F
Burbank, CA 91502
Phone (747) 241-8400

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Armen Jrbashyan Individual 5% Or Greater Direct Ownership InterestPresident/Ceo Jun 6, 2016 50%
Corporate OfficerCeo Jun 6, 2016 50%
Yvonne Addison Individual Corporate DirectorDPCS Jan 1, 2020
W-2 Managing Employee Jan 1, 2020
George Khachaturyan Individual 5% Or Greater Direct Ownership InterestCfo Jun 6, 2016 50%
Corporate OfficerCfo Jun 6, 2016 50%

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1371081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1255779187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 N GLENOAKS BLVD",
            "address_2": "SUITE 301F",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915023201",
            "telephone_number": "747-241-8400",
            "fax_number": "747-241-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 N GLENOAKS BLVD",
            "address_2": "SUITE 301F",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915023201",
            "telephone_number": "747-241-8400",
            "fax_number": "747-241-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD HOME HEALTH & PALLIATIVE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-13",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "JRBASHYAN",
        "authorized_official_first_name": "ARMEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-241-8400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.