Active NPI
Legend Home Health, Inc.
- Home Health Agency
- Torrance, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 550002040
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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, Inc
- Overall star rating
- Ownership
- Proprietary
- Certified
- Dec 20, 2013
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Arevik Shahumyan | W-2 Managing Employee | Apr 14, 2015 | |
| Angelique S Gradney | 5% Or Greater Direct Ownership Interest | Feb 25, 2013 | 100% |
| Corporate Officer | Feb 25, 2013 | 100% | |
| Corporate Director | Feb 25, 2013 | 100% | |
| W-2 Managing Employee | Feb 25, 2013 | 100% | |
| Anna Victoria M. Salva | W-2 Managing Employee | May 1, 2016 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Torrance, CA
- NPI 1912968447
Home health agency
-
- Family Medicine Physician
- Bellflower, CA
- NPI 1114900610
Home health agency
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.