Celebrity Homehealth Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

550000588 Issued in CA

Legal business name

CELEBRITY HOMEHEALTH INC.

Doing business as

Celebrity Home Health

Practice address

942 W Foothill Blvd Ste B
Upland, CA 91786-3783

Phone

(909) 931-3888

Fax

(909) 931-3133

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

David Bustan, ACCOUNTANT

Title

Cfo/Secretary

Phone

(818) 343-4001

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Celebrity Home Health Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 058439

Legal name

CELEBRITY HOMEHEALTH INC.

Doing business as

CELEBRITY HOME HEALTH

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 7, 2008

Last certification

Sep 6, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jan 1, 2007 in CA

Enrollment address

942 W Foothill Blvd
Ste B
Upland, CA 91786-3783

Listed as

Celebrity Home HealthCCN 058439 · All quality measures

Ownership

Proprietary

Certified

Feb 7, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy

Locations

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.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rosamond Claire Valckenier de Greeve, RN, MBA, PHD, MHP, S

  • Mental Health Counselor
  • Longview, WA
  • NPI 1740847094
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1265654362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14950 VENTURA BLVD",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033455",
            "telephone_number": "818-343-4001",
            "fax_number": "818-996-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 W FOOTHILL BLVD STE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863783",
            "telephone_number": "909-931-3888",
            "fax_number": "909-931-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELEBRITY HOMEHEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "BUSTAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO/SECRETARY",
        "authorized_official_telephone_number": "818-343-4001",
        "authorized_official_credential": "ACCOUNTANT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "550000588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "8698138",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Celebrity Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Upland, CA
• Providers in Upland, 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 Feb 6, 2024; 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.