Life Line Health Care Services Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LIFE LINE HEALTH CARE SERVICES INC

Practice address

12444 Victory Blvd Ste 111
North Hollywood, CA 91606-3156

Phone

(747) 248-4479

Fax

(747) 248-4598

NPI assigned

Aug 11, 2020

Last updated

Aug 11, 2020By 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

Hrayr Sargsyan

Title

Ceo

Phone

(747) 248-4479

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 1447861646. Details of each certification follow.

• CCN 757393 Home health agency · Active · Details

Home health agency certification: CCN 757393

Legal name

LIFE LINE HEALTH CARE SERVICES, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 28, 2023

Last certification

Jul 28, 2023

Organization structure

CorporationProprietary

Incorporated

Aug 5, 2020 in CA

Enrollment address

121 W Lexington Dr
Ste 218B
Glendale, CA 91203-2230

Listed as

Life Line Health Care Services IncCCN 757393 · All quality measures

Overall star rating

4.5 of 5

Ownership

-

Certified

Jul 28, 2023

Medicare certification status

ActiveFrom the Provider of Services file

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 1

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

Affiliated clinicians 2

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

• Arbi Ghazarian, M.D.

  • Family Medicine Physician
  • Montrose, CA
  • NPI 1992773253

  Home health agency

  Care Compare affiliation
• Neeraj M Patel, M.D.

  • Internal Medicine Physician
  • Granada Hills, CA
  • NPI 1679830756

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1447861646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12444 VICTORY BLVD STE 111",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063156",
            "telephone_number": "747-248-4479",
            "fax_number": "747-248-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12444 VICTORY BLVD STE 111",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063156",
            "telephone_number": "747-248-4479",
            "fax_number": "747-248-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE LINE HEALTH CARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "SARGSYAN",
        "authorized_official_first_name": "HRAYR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-248-4479"
    },
    "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 North Hollywood, CA
• Providers in North Hollywood, 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 Aug 11, 2020; 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.