Norris Home Health, Inc.
Organization Active NPI Home Health Agency · Pacoima, CA
NPI 1306319785 · NPPES record last updated Jan 8, 2019
Key facts
- NPI
- 1306319785
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- NORRIS HOME HEALTH, INC.
- Practice address
- 10319 Norris Ave Ste B
Pacoima, CA 91331-2220 - Phone
- (747) 222-6189
- Fax
- (818) 484-2360
- NPI assigned
- Jan 8, 2019
- Organization subpart
- No
Authorized official
- Name
- David Kotukyan
- Title
- Ceo
- Phone
- (747) 222-6189
Medicare Care Compare: Home health agency
- Listed as
- Norris Home Health, Inc
- Overall star rating
- ★★★★★ 4.5 of 5
- Ownership
- Proprietary
- Certified
- Mar 9, 2020
- Medicare certification status
- Terminated Voluntary: merger or closure, Jun 1, 2026
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Home health agency certification: CCN 559205
- Legal name
- NORRIS HOME HEALTH, INC
- Doing business as
- TRUSTEDCARE OF LOS ANGELES
- Certification status
- Terminated Voluntary: merger or closure, Jun 1, 2026
- Provider type (POS)
- Home health agency
- Participating since
- Mar 9, 2020
- Last certification
- Mar 9, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Enrollment address
- 1314 W Glenoaks Blvd
Ste 103a
Glendale, CA 91201-1978
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Avkush Berberyan |
5% Or Greater Direct Ownership Interest |
Dec 14, 2023 | |
| Corporate Officer |
Dec 14, 2023 | 100% | |
| Corporate Director |
Dec 14, 2023 | 100% | |
| W-2 Managing Employee |
Dec 14, 2023 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191125000132 | CA | Part a Provider - Home Health Agency | 4587096953 | Practice locations: Glendale, CA |
National Provider Directory
Locations
1314 W Glenoaks Blvd
Ste 103A
Glendale, CA 91201
Phone (747) 222-6189
10319 Norris Ave
Ste B
Pacoima, CA 91331
Phone (747) 222-6189
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
10319 Norris Ave Ste B
Pacoima, CA 91331-2220
Mailing address
10319 Norris Ave Ste B
Pacoima, CA 91331-2220
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.