NPIMap

Organization Active NPI

Santa Home Health Care Inc.

  • Home Health Agency
  • Los Angeles, CA
National Provider Identifier
1730322884
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SANTA HOME HEALTH CARE INC.
Practice address
8281 Melrose Ave.
Suite #205
Los Angeles, CA 90046-6890
Phone
(323) 933-3656
Fax
(323) 933-3682
NPI assigned
Apr 18, 2009
Last updated
Aug 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Authorized official

Name
Ida Gravich
Title
President
Phone
(323) 933-3656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

8281 Melrose Ave.
Suite #205
Los Angeles, CA 90046-6890

Mailing address

8281 Melrose Ave
Suite #205
Los Angeles, CA 90046-6832
Phone (323) 933-3656

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090623000171 CA Part A Provider - Home Health Agency 8527119197 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730322884. Details of each certification follow.

Home health agency certification: CCN 059430

Legal name
SANTA HOME HEALTH CARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 18, 2012
Last certification
Aug 10, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Feb 2, 2009 in CA
Enrollment address
8281 Melrose Ave
Ste 205
Los Angeles, CA 90046-6890

Care Compare: Home health agency

Medicare Care Compare
Listed as
Santa Home Health Care, Inc.CCN 059430 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
May 18, 2012
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
05D1106746Santa Home Health Care8281 Melrose Ave Ste 205, Los Angeles, CA 90046Certificate of waiverOct 20, 2027

National Provider Directory

National Provider Directory

Locations

425 S Fairfax Ave
Ste 310
Los Angeles, CA 90036
Phone (323) 933-3656

8281 Melrose Ave
Ste 205
Los Angeles, CA 90046
Phone (323) 933-3656

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Ilya M Rachman Individual Corporate DirectorMedical Director Jul 7, 2009
Ida F Gravich Individual 5% Or Greater Direct Ownership Interest Feb 2, 2009 100%
Corporate OfficerCeo Feb 2, 2009 100%
W-2 Managing EmployeeCeo Feb 2, 2009 100%
Oksana Romanov Key Individual W-2 Managing EmployeeNursing Supervisor Jun 9, 2016
Operational/Managerial ControlNursing Supervisor Jan 8, 2014
Yelena B Konovalova Individual Corporate DirectorAdministrator, Dopcs Jun 1, 2015
W-2 Managing EmployeeAdministrator, Dopcs Jun 9, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 12

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": "1240012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1730322884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8281 MELROSE AVE",
            "address_2": "SUITE #205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900466832",
            "telephone_number": "323-933-3656",
            "fax_number": "323-933-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8281 MELROSE AVE.",
            "address_2": "SUITE #205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900466890",
            "telephone_number": "323-933-3656",
            "fax_number": "323-933-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA HOME HEALTH CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-18",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "GRAVICH",
        "authorized_official_first_name": "IDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-933-3656"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.