Organization Active NPI

Elegant Home Health Care Inc.

  • Home Health Agency
  • La Crescenta, CA
National Provider Identifier
1578060760
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ELEGANT HOME HEALTH CARE INC.
Practice address
3857 Foothill Blvd Ste 18
La Crescenta, CA 91214-1658
Phone
(818) 465-2222
NPI assigned
Apr 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Authorized official

Name
Grigor Oktanian
Title
Ceo
Phone
(818) 465-2222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X CA Primary

Addresses

Primary practice location

3857 Foothill Blvd Ste 18
La Crescenta, CA 91214-1658

Mailing address

3857 Foothill Blvd Ste 18
La Crescenta, CA 91214-1658

Other identifiers 1

IdentifierTypeStateIssuer
1MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200408001680 CA Part A Provider - Home Health Agency 9931538238 Practice locations: Glendale, CA

Home health agency certification: CCN 559428

Legal name
ELEGANT HOME HEALTH CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 17, 2020
Last certification
Jul 21, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 8, 2018 in CA
Enrollment address
1259 S Glendale Ave
Ste H
Glendale, CA 91205-3298

Care Compare: Home health agency

Medicare Care Compare
Listed as
Elegant Home Health Care, IncCCN 559428
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Jul 17, 2020
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

1259 S Glendale Ave
Ste H
Glendale, CA 91205
Phone (818) 465-2222

Ownership & related parties

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.

NameRoleSinceShare
Hakop Tiflizyan Individual 5% Or Greater Direct Ownership InterestCeo Mar 8, 2018 100%
Corporate OfficerCeo-Chairman of Board Mar 8, 2018 100%
Corporate DirectorCeo Mar 8, 2018 100%
W-2 Managing EmployeeCeo Mar 8, 2018 100%
Operational/Managerial ControlCeo Mar 8, 2018

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523491200000",
    "number": "1578060760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3857 FOOTHILL BLVD STE 18",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912141658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3857 FOOTHILL BLVD STE 18",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912141658",
            "telephone_number": "818-465-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEGANT HOME HEALTH CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A",
        "authorized_official_last_name": "OKTANIAN",
        "authorized_official_first_name": "GRIGOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-465-2222"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crescenta, CA

Sources for this page

Verify at the official NPI Registry.