Crystal Health Services Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CRYSTAL HEALTH SERVICES INC

Practice address

14664 Victory Blvd # 208
Van Nuys, CA 91411-1621

Phone

(818) 294-0752

Fax

(818) 279-2566

NPI assigned

Oct 8, 2019

Last updated

Oct 30, 2024By 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

Mr. Tigran Sahakyan

Title

Ceo

Phone

(818) 294-0752

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 1639711930. Details of each certification follow.

• CCN 757123 Home health agency · Active · Details

Home health agency certification: CCN 757123

Legal name

CRYSTAL HEALTH SERVICES INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 22, 2022

Last certification

Nov 22, 2022

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Aug 26, 2019 in CA

Enrollment address

3504 W Magnolia Blvd
Ste 3
Burbank, CA 91505-2911
HHA Branch

Listed as

Crystal Health Services Inc.CCN 757123 · All quality measures

Overall star rating

3 of 5

Ownership

Proprietary

Certified

Nov 22, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Sunil G. Sujan, M.D.

  • Internal Medicine Physician
  • Santa Monica, CA
  • NPI 1598740474

  Home health agency

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1639711930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14664 VICTORY BLVD # 208",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111621",
            "telephone_number": "818-294-0752",
            "fax_number": "323-967-2871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14664 VICTORY BLVD # 208",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111621",
            "telephone_number": "818-294-0752",
            "fax_number": "818-279-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-08",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "SAHAKYAN",
        "authorized_official_first_name": "TIGRAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-294-0752",
        "authorized_official_name_prefix": "Mr."
    },
    "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 Oct 30, 2024; 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.