Golden Age Home Health Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

550000856 Issued in CA

Legal business name

GOLDEN AGE HOME HEALTH INC

Doing business as

PRN Home Health Services

Practice address

15600 Devonshire St Ste 206
Granada Hills, CA 91344-7242

Phone

(818) 761-5511

Fax

(818) 761-6611

NPI assigned

May 8, 2007

Organization subpart

No

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

Authorized official

Name

Amanteflor P Villanueva

Title

Ceo

Phone

(818) 761-5511

Specialties & licenses 1

Addresses

Other names 1

• PRN HOME HEALTH SERVICES Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 059091

Legal name

GOLDEN AGE HOME HEALTH INC

Doing business as

PRN HOME HEALTH SERVICES

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 27, 2009

Last certification

Jun 22, 2018

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Apr 30, 2007 in CA

Enrollment address

15600 Devonshire St
Ste 206
Granada Hills, CA 91344-7242

Listed as

PRN Home Health ServicesCCN 059091 · All quality measures

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

Jul 27, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Jay B Madhure, M.D.

  • Adolescent Medicine (Family Medicine) Physician
  • Granada Hills, CA
  • NPI 1770518714

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Brian N Evans, M.D.

  • Plastic Surgery Physician
  • West Hills, CA
  • NPI 1932159977

  Home health agency

  Care Compare affiliation
• Hanan Lobel, MD

  • Internal Medicine Physician
  • Van Nuys, CA
  • NPI 1174612287

  Home health agency

  Care Compare affiliation
• Josef Lobel, M.D.

  • Internal Medicine Physician
  • Van Nuys, CA
  • NPI 1295769230

  Home health agency

  Care Compare affiliation
• Racquel S Quema, M.D.

  • Family Medicine Physician
  • Burbank, CA
  • NPI 1033369467

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1417160045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 DEVONSHIRE ST STE 206",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913447242",
            "telephone_number": "818-761-5511",
            "fax_number": "818-761-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 DEVONSHIRE ST STE 206",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913447242",
            "telephone_number": "818-761-5511",
            "fax_number": "818-761-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN AGE HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "AMANTEFLOR",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-761-5511"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "550000856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRN HOME HEALTH SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wayne James Gilmour
• Sharon Gitman, R.P.T.
• Gladys Field, Advanced Practice Nursing Corporation
• Globus Senior Living Inc
• Florence Gold, OT
• Golden Path Inc
• Golden Path Recovery Center Inc
• Golden Touch Home Health Care, Inc.
• Golden Years Senior Living #1 Inc. (Golden Years Senior Living)
• Golden Years Senior Living, Inc

• Home Health Agency in Granada Hills, CA
• Providers in Granada 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 Jun 23, 2015; 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.