St. Theresa Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ST. THERESA HOME HEALTH, INC.

Practice address

14545 Friar St Ste 202G
Van Nuys, CA 91411-2398

Phone

(818) 812-0328

NPI assigned

Jan 5, 2020

Last updated

Jan 5, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Varduhi Victoria Avetisyan

Title

President

Phone

(818) 812-0328

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598304784. Details of each certification follow.

• CCN 753101 Home health agency · Active · Details

Home health agency certification: CCN 753101

Legal name

ST THERESA HOME HEALTH INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 18, 2022

Last certification

Feb 18, 2022

Organization structure

CorporationProprietary

Incorporated

Sep 11, 2019 in CA

Enrollment address

14545 Friar St
Ste 202G
Van Nuys, CA 91411-2398

Listed as

St. Theresa Home Health, Inc.CCN 753101 · All quality measures

Overall star rating

2 of 5

Ownership

-

Certified

Feb 18, 2022

Medicare certification status

ActiveFrom the Provider of Services file

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": "1578182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578182400000",
    "number": "1598304784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14545 FRIAR ST STE 202G",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112398",
            "telephone_number": "818-812-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14545 FRIAR ST STE 202G",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112398",
            "telephone_number": "818-812-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. THERESA HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-05",
        "last_updated": "2020-01-05",
        "certification_date": "2020-01-05",
        "status": "A",
        "authorized_official_last_name": "AVETISYAN",
        "authorized_official_first_name": "VARDUHI",
        "authorized_official_middle_name": "VICTORIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-812-0328"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2020; 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.