Organization Active NPI

Community Adult Home Health Care Inc

  • Home Health Agency
  • Van Nuys, CA
National Provider Identifier
1588319552
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
COMMUNITY ADULT HOME HEALTH CARE INC
Practice address
13615 Victory Blvd Ste 118
Van Nuys, CA 91401-1777
Phone
(818) 475-1530
Fax
(818) 475-1530
NPI assigned
Feb 17, 2022
Last updated
Feb 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Authorized official

Name
Grigor Khechoyan
Title
Ceo
Phone
(818) 475-1530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

13615 Victory Blvd Ste 118
Van Nuys, CA 91401-1777

Mailing address

13615 Victory Blvd Ste 118
Van Nuys, CA 91401-1777
Phone (818) 475-1530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240216002291 CA Part A Provider - Home Health Agency 1254775372 Practice locations: Van Nuys, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1588319552. Details of each certification follow.

Home health agency certification: CCN 757801

Legal name
COMMUNITY ADULT HOME HEALTH CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 20, 2024
Last certification
Nov 15, 2024
Organization structure
CorporationProprietary
Enrollment address
13615 Victory Blvd
Ste 118
Van Nuys, CA 91401-1777

Care Compare: Home health agency

Medicare Care Compare
Listed as
Community Adult Home Health Care, Inc.CCN 757801 · All quality measures
Ownership
-
Certified
Nov 20, 2024
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

13615 Victory Blvd
Ste 118
Van Nuys, CA 91401
Phone (818) 538-5313

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
Grigor Khechoyan Individual 5% Or Greater Direct Ownership InterestCeo Jan 12, 2022 100%
Corporate OfficerCeo Jan 12, 2022 100%
Corporate DirectorCeo Jan 12, 2022 100%
W-2 Managing EmployeeCeo Jan 12, 2022 100%

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1588319552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13615 VICTORY BLVD STE 118",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011777",
            "telephone_number": "818-475-1530",
            "fax_number": "818-475-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13615 VICTORY BLVD STE 118",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011777",
            "telephone_number": "818-475-1530",
            "fax_number": "818-475-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ADULT HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "KHECHOYAN",
        "authorized_official_first_name": "GRIGOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-475-1530"
    },
    "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.