Organization Active NPI

Eternity Home Health Care, Inc.

  • Home Health Agency
  • Los Angeles, CA
National Provider Identifier
1619542784
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ETERNITY HOME HEALTH CARE, INC.
Practice address
1480 Colorado Blvd Ste 125
Los Angeles, CA 90041-2373
Phone
(818) 355-0616
NPI assigned
May 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Authorized official

Name
Harutyun Sargsyan
Title
Ceo
Phone
(818) 355-0616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1480 Colorado Blvd Ste 125
Los Angeles, CA 90041-2373

Mailing address

1480 Colorado Blvd Ste 125
Los Angeles, CA 90041-2373
Phone (818) 355-0616

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221205001030 CA Part A Provider - Home Health Agency 8729457395 Practice locations: Los Angeles, CA

Home health agency certification: CCN 757497

Legal name
ETERNITY HOME HEALTH CARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 6, 2023
Last certification
Dec 6, 2023
Organization structure
CorporationProprietary
Incorporated
May 17, 2021 in CA
Enrollment address
1480 Colorado Blvd
Ste 125
Los Angeles, CA 90041-2373

Care Compare: Home health agency

Medicare Care Compare
Listed as
Eternity Home Health Care, IncCCN 757497 · All quality measures
Overall star rating
1.5 of 5
Ownership
-
Certified
Dec 6, 2023
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

1480 Colorado Blvd
Ste 125
Los Angeles, CA 90041
Phone (323) 474-6712

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
Harutyun Sargysan Individual 5% Or Greater Direct Ownership InterestCeo May 17, 2021 100%
Corporate OfficerCeo-Chairman of Board May 17, 2021 100%
Corporate DirectorCeo May 17, 2021 100%
W-2 Managing EmployeeCeo May 17, 2021 100%
Operational/Managerial ControlCeo May 17, 2021 100%

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": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1619542784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 COLORADO BLVD STE 125",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412373",
            "telephone_number": "818-355-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 COLORADO BLVD STE 125",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412373",
            "telephone_number": "818-355-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETERNITY HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A",
        "authorized_official_last_name": "SARGSYAN",
        "authorized_official_first_name": "HARUTYUN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-355-0616"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.