Angel City Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ANGEL CITY HOME HEALTH, INC.

Practice address

511 E Harvard St Ste 5
Glendale, CA 91205-1184

Phone

(747) 210-9300

NPI assigned

Apr 24, 2018

Last updated

Apr 24, 2018By 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

Armen Hakobyan

Title

President

Phone

(818) 261-3663

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 1629566740. Details of each certification follow.

• CCN 753111 Home health agency · Active · Details

Home health agency certification: CCN 753111

Legal name

ANGEL CITY HOME HEALTH, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 29, 2021

Last certification

Mar 18, 2021

Organization structure

CorporationProprietary

Incorporated

Feb 26, 2018 in CA

Enrollment address

511 E Harvard St
Ste 5
Glendale, CA 91205-1184

Listed as

Angel City Home Health, IncCCN 753111 · All quality measures

Ownership

-

Certified

Mar 29, 2021

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": "1524528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524528000000",
    "number": "1629566740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 E HARVARD ST STE 5",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 E HARVARD ST STE 5",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051184",
            "telephone_number": "747-210-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL CITY HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-04-24",
        "status": "A",
        "authorized_official_last_name": "HAKOBYAN",
        "authorized_official_first_name": "ARMEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-261-3663"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.