NPIMap

Organization Active NPI

Family Care Home Health Agency Inc

  • Home Health Agency
  • Van Nuys, CA
National Provider Identifier
1558724435
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
FAMILY CARE HOME HEALTH AGENCY INC
Practice address
7136 Haskell Ave Suite 215
Van Nuys, CA 91406-7136
Phone
(818) 855-4101
NPI assigned
Mar 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Authorized official

Name
Maricris Soria
Title
Ceo/President
Phone
(818) 855-1401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

7136 Haskell Ave Suite 215
Van Nuys, CA 91406-7136

Mailing address

7136 Haskell Ave Suite 215
Van Nuys, CA 91406-7136

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180410000017 CA Part A Provider - Home Health Agency 9830452663 Practice locations: Van Nuys, CA

Home health agency certification: CCN 053192

Legal name
FAMILY CARE HOME HEALTH AGENCY, INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 20, 2018
Last certification
Jun 20, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Oct 22, 2015 in CA
Enrollment address
15643 Sherman Way
Ste 210
Van Nuys, CA 91406-8202

Care Compare: Home health agency

Medicare Care Compare
Listed as
Family Care Home Health Agency, Inc.CCN 053192 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Jun 20, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2192557Family Care Home Health Agency, Inc15643 Sherman Way Suite 210, Van Nuys, CA 91406Certificate of waiverSep 10, 2026

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
Lyubov Karapetyan Individual 5% Or Greater Direct Ownership InterestOwner Jun 23, 2021 50%
Corporate OfficerCfo/Board Member/50% Owner Jun 23, 2021 50%
Corporate DirectorCfo/Board Member/50% Owner Jun 23, 2021 50%
W-2 Managing EmployeeCfo/Board Member/50% Owner Jun 23, 2021 50%
Maricris M Soria Individual 5% Or Greater Direct Ownership InterestOwner Jun 23, 2021 50%
Corporate OfficerAdmin/Ceo/Sec/Pres/BM/50% Owner Jun 23, 2021 50%
Corporate DirectorAdmin/Ceo/Sec/Pres/BM/50% Owner Jun 23, 2021 50%
W-2 Managing EmployeeAdmin/Ceo/Sec/Pres/BM/50% Owner Jun 23, 2021 50%

Practitioners & affiliated clinicians

Affiliated clinicians 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1558724435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7136 HASKELL AVE SUITE 215",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914067136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7136 HASKELL AVE SUITE 215",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914067136",
            "telephone_number": "818-855-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE HOME HEALTH AGENCY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-30",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "SORIA",
        "authorized_official_first_name": "MARICRIS",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "818-855-1401"
    },
    "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.