La Guardian Health Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LA GUARDIAN HEALTH CARE INC

Practice address

6501 Foothill Blvd
Suite 203B
Tujunga, CA 91042-2765

Phone

(818) 273-9807

Fax

(818) 495-2523

NPI assigned

Mar 14, 2012

Organization subpart

No

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

Authorized official

Name

Rouzanna Davitian

Title

Owner

Phone

(818) 273-9807

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 059690

Legal name

LA GUARDIAN HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 17, 2015

Last certification

Oct 25, 2018

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Feb 27, 2012 in CA

Enrollment address

6501 Foothill Blvd
Ste 203B
Tujunga, CA 91042-2768
HHA Branch

Listed as

La Guardian Health Care IncCCN 059690

Overall star rating

4 of 5

Ownership

Proprietary

Certified

Nov 17, 2015

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 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": "1331683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1487929162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 FOOTHILL BLVD",
            "address_2": "SUITE 203B",
            "city": "TUJUNGA",
            "state": "CA",
            "postal_code": "910422765",
            "telephone_number": "818-273-9807",
            "fax_number": "818-495-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 FOOTHILL BLVD",
            "address_2": "SUITE 203B",
            "city": "TUJUNGA",
            "state": "CA",
            "postal_code": "910422765",
            "telephone_number": "818-273-9807",
            "fax_number": "818-495-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA GUARDIAN HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-14",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "DAVITIAN",
        "authorized_official_first_name": "ROUZANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-273-9807"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sergey Dmitriyevich Kustov, PHARMD
• Vasiliky Kyriakopoulos, LCSW
• L.a. Enhanced Care Management Inc.
• La Guardian Hospice Inc
• Dan T La, MD
• Lavista Healthcare, in.C
• Lifeline Clinical Laboratory Inc
• Lifelong Home Health Inc

• All providers in Tujunga, CA
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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.