Organization Active NPI

La Memorial Home Health Care

  • Home Health Agency
  • Van Nuys, CA
National Provider Identifier
1548990302
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LA MEMORIAL HOME HEALTH CARE
Practice address
17620 Sherman Way Ste 105a
Van Nuys, CA 91406-3527
Phone
(800) 551-9161
Fax
(800) 551-9161
NPI assigned
Jun 14, 2022
Organization subpart
Yes
Parent organization
LA MEMORIAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Ms. Mariam Safaryan
Title
Ceo
Phone
(800) 551-9161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

17620 Sherman Way Ste 105a
Van Nuys, CA 91406-3527

Mailing address

17620 Sherman Way Ste 105a
Van Nuys, CA 91406-3527
Phone (800) 551-9161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241031001725 CA Part A Provider - Home Health Agency 2466985205 Practice locations: Van Nuys, CA

Home health agency certification: CCN 758058

Legal name
LA MEMORIAL HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 28, 2025
Last certification
Jul 15, 2025
Organization structure
CorporationProprietary
Enrollment address
17620 Sherman Way
Ste 105a
Van Nuys, CA 91406
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
La Memorial Home Health CareCCN 758058 · All quality measures
Ownership
-
Certified
Jul 28, 2025
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Mariam Safaryan Individual 5% Or Greater Indirect Ownership InterestCeo/Pres/Cfo/Sec/Brdmbr/100Indir Jun 15, 2022 100%
Corporate OfficerCeo/Pres/Cfo/Sec/Brdmbr/100Indir Jun 15, 2022 100%
Corporate DirectorCeo/Pres/Cfo/Sec/Brdmbr/100Indir Jun 15, 2022 100%
W-2 Managing EmployeeCeo/Pres/Cfo/Sec/Brdmbr/100Indir Jun 15, 2022 100%
La Memorial Group Organization, Van Nuys, CA Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 24, 2022 100%

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1548990302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17620 SHERMAN WAY STE 105A",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914063527",
            "telephone_number": "800-551-9161",
            "fax_number": "800-551-9161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17620 SHERMAN WAY STE 105A",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914063527",
            "telephone_number": "800-551-9161",
            "fax_number": "800-551-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA MEMORIAL HOME HEALTH CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LA MEMORIAL GROUP",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "SAFARYAN",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-551-9161",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.