Active NPI
Libra Home Health Care. Inc.
- Home Health Agency
- Glendale, CA
National Provider Identifier
1609265339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 550000498
- Legal business name
- LIBRA HOME HEALTH CARE. INC.
- Practice address
- 1241 S. Glendale Ave.
Suite 304E
Glendale, CA 91205-3204 - Phone
- (818) 405-9473
- Fax
- (818) 459-6995
- NPI assigned
- Jan 19, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Karapet Gary Tiflizyan
- Title
- Ceo
- Phone
- (818) 405-9473
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 550000498 | CA | Primary |
Addresses
Primary practice location
1241 S. Glendale Ave.
Suite 304E
Glendale, CA 91205-3204
Mailing address
1241 S. Glendale Ave.
Suite 304E
Glendale, CA 91205-3204
Phone (818) 405-9473
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150225000488 | CA | Part A Provider - Home Health Agency | 1254657935 | Practice locations: Glendale, CA |
Home health agency certification: CCN 059735
- Legal name
- LIBRA HOME HEALTH CARE INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 22, 2016
- Last certification
- Mar 8, 2019
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Jan 8, 2014 in CA
- Enrollment address
- 1215 E Colorado St
Ste 201
Glendale, CA 91205-1494
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Libra Home Health Care, Inc.
- Overall star rating
- Ownership
- Proprietary
- Certified
- Apr 22, 2016
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2134651 | Libra Home Health Care Inc | Certificate of waiver | Aug 6, 2027 |
National Provider Directory
National Provider DirectoryLocations
1215 E Colorado St
Ste 201
Glendale, CA 91205
Phone (818) 574-1441
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Karapet Tiflizyan | 5% Or Greater Direct Ownership Interest | Jan 19, 2015 | 100% |
| Corporate Officer | Jan 19, 2015 | 100% | |
| Corporate Director | Jan 19, 2015 | 100% | |
| W-2 Managing Employee | Jan 19, 2015 | 100% | |
| Tadd G Nares | W-2 Managing Employee | Jan 19, 2015 |
Practitioners & affiliated clinicians
Affiliated clinicians 1
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": "1421625600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1450310400000",
"number": "1609265339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1241 S. GLENDALE AVE.",
"address_2": "SUITE 304E",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912053204",
"telephone_number": "818-405-9473",
"fax_number": "818-459-6995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1241 S. GLENDALE AVE.",
"address_2": "SUITE 304E",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912053204",
"telephone_number": "818-405-9473",
"fax_number": "818-459-6995"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIBRA HOME HEALTH CARE. INC.",
"organizational_subpart": "NO",
"enumeration_date": "2015-01-19",
"last_updated": "2015-12-17",
"status": "A",
"authorized_official_last_name": "TIFLIZYAN",
"authorized_official_first_name": "KARAPET",
"authorized_official_middle_name": "GARY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "818-405-9473"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "CA",
"license": "550000498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.