NPIMap

Organization Active NPI

Distinctive Home Health, Inc.

  • Home Health Agency
  • La Crescenta, CA
National Provider Identifier
1649760281
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
DISTINCTIVE HOME HEALTH, INC.
Practice address
4502 Dyer St Ste 105
La Crescenta, CA 91214-2857
Phone
(818) 484-5730
NPI assigned
May 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
Mr. Vilen Mnatsakanyan
Title
President/Ceo
Phone
(818) 484-5730

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X CA Primary
Home Health Agency 251E00000X

Addresses

Primary practice location

4502 Dyer St Ste 105
La Crescenta, CA 91214-2857

Mailing address

4502 Dyer St Ste 105
La Crescenta, CA 91214-2857
Phone (818) 484-5730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
Home infusion therapy
Medicare-enrolled home infusion therapy supplier

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200309000231 CA Part A Provider - Home Health Agency 7012345960 Practice locations: La Crescenta, CA
O20260311004492 CA Part B Supplier - Home Infusion Therapy Supplier 7012345960 Practice locations: La Crescenta, CA

Home health agency certification: CCN 559263

Legal name
DISTINCTIVE HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 22, 2020
Last certification
May 22, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Dec 4, 2017 in CA
Enrollment address
4502 Dyer St
Ste 105
La Crescenta, CA 91214-2857

Care Compare: Home health agency

Medicare Care Compare
Listed as
Distinctive Home Health, IncCCN 559263
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
May 22, 2020
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
05D2212498Distinctive Home Health Inc4502 Dyer Street, Suite 105, La Crescenta, CA 91214Certificate of waiverFeb 3, 2027

National Provider Directory

National Provider Directory

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
Vilen Mnatsakanyan Individual 5% Or Greater Direct Ownership Interest Dec 4, 2017 100%
Corporate OfficerCeo-Chairman of Board Dec 4, 2017 100%
Corporate DirectorCeo Dec 4, 2017 100%
W-2 Managing EmployeeCeo Dec 4, 2017 100%
Operational/Managerial ControlCeo Dec 4, 2017 100%

Practitioners & affiliated clinicians

Affiliated clinicians 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1649760281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 DYER ST STE 105",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912142857",
            "telephone_number": "818-484-5730",
            "fax_number": "747-286-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 DYER ST STE 105",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912142857",
            "telephone_number": "818-484-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVE HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-17",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "MNATSAKANYAN",
        "authorized_official_first_name": "VILEN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "818-484-5730",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crescenta, CA

Sources for this page

Verify at the official NPI Registry.