Organization Active NPI

Sage Home Health Inc

  • Home Health Agency
  • Van Nuys, CA
National Provider Identifier
1710476981
Registry record updated May 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SAGE HOME HEALTH INC
Practice address
14664 Victory Blvd Ste 109
Van Nuys, CA 91411-1621
Phone
(818) 813-0061
NPI assigned
May 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2018

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

Authorized official

Name
Sargis Chinaryan
Title
Ceo
Phone
(818) 813-0061

Specialties & licenses 1

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

Addresses

Primary practice location

14664 Victory Blvd Ste 109
Van Nuys, CA 91411-1621

Mailing address

14664 Victory Blvd Ste 109
Van Nuys, CA 91411-1621

Other identifiers 1

IdentifierTypeStateIssuer
1MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190801000847 CA Part A Provider - Home Health Agency 4789910480 Practice locations: Van Nuys, CA

Home health agency certification: CCN 559146

Legal name
SAGE HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 18, 2019
Last certification
Nov 18, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 14, 2018 in CA
Enrollment address
14664 Victory Blvd
Suite 109
Van Nuys, CA 91411-1621

Care Compare: Home health agency

Medicare Care Compare
Listed as
Sage Home Health IncCCN 559146
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Nov 18, 2019
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

14664 Victory Blvd
Ste 109
Van Nuys, CA 91411
Phone (818) 813-0061

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
Sargis Chinaryan Individual 5% Or Greater Direct Ownership InterestCeo Mar 14, 2018 100%
Corporate OfficerCeo-Chairman of Board Mar 14, 2018 100%
Corporate DirectorCeo Mar 14, 2018 100%
W-2 Managing EmployeeCeo Mar 14, 2018 100%
Operational/Managerial ControlCeo Mar 14, 2018 100%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1525305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525305600000",
    "number": "1710476981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14664 VICTORY BLVD STE 109",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14664 VICTORY BLVD STE 109",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111621",
            "telephone_number": "818-813-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-03",
        "last_updated": "2018-05-03",
        "status": "A",
        "authorized_official_last_name": "CHINARYAN",
        "authorized_official_first_name": "SARGIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-813-0061"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.