Southland Home Health Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SOUTHLAND HOME HEALTH INC

Practice address

14545 Friar St Ste 242
Van Nuys, CA 91411-2397

Phone

(818) 945-4163

Fax

(805) 291-5055

NPI assigned

Dec 10, 2019

Last updated

Dec 10, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Levon Patanyan

Title

Ceo

Phone

(818) 945-4163

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306483235. Details of each certification follow.

• CCN 559442 Home health agency · Active · Details

Home health agency certification: CCN 559442

Legal name

SOUTHLAND HOME HEALTH INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 4, 2021

Last certification

Mar 4, 2021

Organization structure

CorporationProprietary

Enrollment address

3151 Cahuenga Blvd W
Ste 305
Los Angeles, CA 90068-1768

Listed as

Southland Home Health IncCCN 559442 · All quality measures

Overall star rating

3.5 of 5

Ownership

-

Certified

Mar 4, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1306483235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14545 FRIAR ST STE 242",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112397",
            "telephone_number": "818-945-4163",
            "fax_number": "805-291-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14545 FRIAR ST STE 242",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112397",
            "telephone_number": "818-945-4163",
            "fax_number": "805-291-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-10",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "PATANYAN",
        "authorized_official_first_name": "LEVON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-945-4163"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Van Nuys, CA
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• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.