St. John's Healthcare Services

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ST. JOHN'S HEALTHCARE SERVICES

Practice address

14545 Friar St Ste 322-2
Van Nuys, CA 91411-2397

Phone

(818) 426-7730

Fax

(818) 855-1925

NPI assigned

Nov 12, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Arlene V Roque, LVN

Title

Ceo/Cfo/Sec/Owner

Phone

(818) 426-7730

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 1356007520. Details of each certification follow.

• CCN 757852 Home health agency · Active · Details

Home health agency certification: CCN 757852

Legal name

ST JOHN'S HEALTHCARE SERVICES

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 15, 2024

Last certification

Oct 23, 2024

Organization structure

CorporationProprietary

Incorporated

Oct 25, 2021 in CA

Enrollment address

11260 Wilbur Ave
Ste 302
Porter Ranch, CA 91326-2450

Listed as

St. John's Healthcare ServicesCCN 757852 · All quality measures

Ownership

-

Certified

Nov 15, 2024

Medicare certification status

ActiveFrom the Provider of Services file

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.

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636675200000",
    "number": "1356007520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14545 FRIAR ST STE 322-2",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112397",
            "telephone_number": "818-426-7730",
            "fax_number": "818-855-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14545 FRIAR ST STE 322-2",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112397",
            "telephone_number": "818-426-7730",
            "fax_number": "818-855-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN'S HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-12",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A",
        "authorized_official_last_name": "ROQUE",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CEO/CFO/SEC/OWNER",
        "authorized_official_telephone_number": "818-426-7730",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Paul Home Health Services Inc
• St Peter's Hospice Services
• St Rita's Hospice Care Inc
• St Rose Hospice Care Inc
• St. Charbel Hospice, Inc.
• St. Jude Home Health Care
• St. Lilly Hospice, Inc.
• St. Luke's Hospice Agency
• St. Mary's Hospice and Palliative Care, Inc.
• St. Paul Medical Clinic a Professional Corporation

• Home Health Agency in Van Nuys, CA
• Providers in Van Nuys, 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 Nov 12, 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.