NPIMap

Organization Active NPI

United Home Health Care LLC

  • Home Health Agency
  • Bakersfield, CA
National Provider Identifier
1639627433
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
UNITED HOME HEALTH CARE LLC
Practice address
1717 30TH St
Bakersfield, CA 93301-1909
Phone
(661) 493-0373
Fax
(661) 493-0377
NPI assigned
Sep 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Authorized official

Name
Mari Grigoryan, RN, BSN, PHN
Title
Administrator
Phone
(661) 493-0373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1717 30TH St
Bakersfield, CA 93301-1909

Mailing address

1717 30TH St
Bakersfield, CA 93301-1909
Phone (661) 493-0373

Other identifiers 1

IdentifierTypeStateIssuer
1639627433MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170130001478 CA Part A Provider - Home Health Agency 5395027270 Practice locations: Bakersfield, CA

Home health agency certification: CCN 053177

Legal name
UNITED HOME HEALTH CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 6, 2018
Last certification
Aug 6, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Apr 8, 2016 in CA
Enrollment address
1717 30TH St
Bakersfield, CA 93301-1909

Care Compare: Home health agency

Medicare Care Compare
Listed as
United Home Health Care LLCCCN 053177
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Aug 6, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2135648United Home Health Care LLC1717 30TH St, Bakersfield, CA 93301Certificate of waiverAug 23, 2027

National Provider Directory

National Provider Directory

Locations

1717 30th St
Bakersfield, CA 93301
Phone (661) 322-2125

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.

NameRoleSinceShare
Vahan Avetisyan Individual Corporate DirectorPresident, Board Member Apr 8, 2016 50%
Mari K Grigoryan Individual 5% Or Greater Direct Ownership Interest Apr 8, 2016 100%
Corporate DirectorVice President Apr 8, 2016 50%
W-2 Managing EmployeeAdministrator Apr 8, 2016 100%

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1474416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1639627433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 30TH ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933011909",
            "telephone_number": "661-493-0373",
            "fax_number": "661-493-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 30TH ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933011909",
            "telephone_number": "661-493-0373",
            "fax_number": "661-493-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-21",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A",
        "authorized_official_last_name": "GRIGORYAN",
        "authorized_official_first_name": "MARI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "661-493-0373",
        "authorized_official_credential": "RN, BSN, PHN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639627433",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.