Prestige Life Home Health Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PRESTIGE LIFE HOME HEALTH CARE, INC.

Practice address

5311 Topanga Canyon Blvd Ste 208
Woodland Hills, CA 91364-1754

Phone

(747) 444-9146

Fax

(818) 960-0290

NPI assigned

Apr 21, 2021

Organization subpart

No

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

Authorized official

Name

Lilit Bouniatian

Title

Ceo

Phone

(747) 444-9146

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757284

Legal name

PRESTIGE LIFE HOME HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 5, 2023

Last certification

Mar 22, 2023

Organization structure

CorporationProprietary

Incorporated

Mar 4, 2021 in CA

Enrollment address

13735 Victory Blvd
Ste 8
Van Nuys, CA 91401-6736

Listed as

Prestige Life Home Health Care, Inc.CCN 757284

Overall star rating

5 of 5

Ownership

-

Certified

Apr 5, 2023

Medicare certification status

ActiveFrom the Provider of Services file

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": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1316529167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5311 TOPANGA CANYON BLVD STE 208",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641754",
            "telephone_number": "747-444-9146",
            "fax_number": "818-960-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5311 TOPANGA CANYON BLVD STE 208",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641754",
            "telephone_number": "747-444-9146",
            "fax_number": "818-960-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE LIFE HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "BOUNIATIAN",
        "authorized_official_first_name": "LILIT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-444-9146"
    },
    "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 Woodland Hills, CA
• Providers in Woodland Hills, 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 Apr 21, 2021; 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.