Organization Active NPI

Legend Home Health, Inc.

  • Home Health Agency
  • Torrance, CA
National Provider Identifier
1710262001
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
550002040 Issued in CA
Legal business name
LEGEND HOME HEALTH, INC.
Practice address
3510 Torrance Blvd Ste 111
Torrance, CA 90503-4814
Phone
(310) 540-4059
Fax
(310) 540-4074
NPI assigned
Oct 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Authorized official

Name
Mrs. Angelique Gradney
Title
Ceo
Phone
(310) 540-4059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 550002040 CA Primary

Addresses

Primary practice location

3510 Torrance Blvd Ste 111
Torrance, CA 90503-4814

Mailing address

3510 Torrance Blvd Ste 111
Torrance, CA 90503-4814
Phone (310) 540-4059

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130410000133 CA Part A Provider - Home Health Agency 3375716681 Practice locations: Torrance, CA

Home health agency certification: CCN 059578

Legal name
LEGEND HOME HEALTH, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 20, 2013
Last certification
Oct 9, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Aug 25, 2011 in CA
Enrollment address
3510 Torrance Blvd
Ste 111
Torrance, CA 90503-4824

Care Compare: Home health agency

Medicare Care Compare
Listed as
Legend Home Health, IncCCN 059578
Overall star rating
1.5 of 5
Ownership
Proprietary
Certified
Dec 20, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

21707 Hawthorne Blvd
Ste 303
Torrance, CA 90503
Phone (310) 540-4059

3510 Torrance Blvd
Ste 111
Torrance, CA 90503
Phone (310) 540-4059

14640 Victory Blvd
Ste 221
Van Nuys, CA 91411
Phone (818) 901-1002

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Arevik Shahumyan Individual W-2 Managing EmployeeAdmin/DPCS Apr 14, 2015
Angelique S Gradney Individual 5% Or Greater Direct Ownership InterestCeo / Secretary Feb 25, 2013 100%
Corporate OfficerCeo / Secretary Feb 25, 2013 100%
Corporate DirectorCeo / Secretary Feb 25, 2013 100%
W-2 Managing EmployeeCeo / Secretary Feb 25, 2013 100%
Anna Victoria M. Salva Individual W-2 Managing EmployeeAdministrator May 1, 2016 100%

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1318896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1710262001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 TORRANCE BLVD STE 111",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034814",
            "telephone_number": "310-540-4059",
            "fax_number": "310-540-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 TORRANCE BLVD STE 111",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034814",
            "telephone_number": "310-540-4059",
            "fax_number": "310-540-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGEND HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-18",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "GRADNEY",
        "authorized_official_first_name": "ANGELIQUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-540-4059",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "550002040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.