Organization Active NPI

Constellation Home Health Services, LLC

  • Home Health Agency
  • Northridge, CA
National Provider Identifier
1740649045
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CONSTELLATION HOME HEALTH SERVICES, LLC
Practice address
9045 Corbin Ave
Suite 301
Northridge, CA 91324-3300
Phone
(818) 399-6984
NPI assigned
Feb 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Authorized official

Name
Zenedie Calonzo
Title
Managing Member
Phone
(818) 399-6984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

9045 Corbin Ave
Suite 301
Northridge, CA 91324-3300

Mailing address

9045 Corbin Ave
Suite 301
Northridge, CA 91324-3300
Phone (818) 399-6984

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160426001273 CA Part A Provider - Home Health Agency 5890094817 Practice locations: Northridge, CA

Home health agency certification: CCN 553137

Legal name
CONSTELLATION HOME HEALTH SERVICES LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 24, 2018
Last certification
Aug 3, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Feb 4, 2016 in CA
Enrollment address
9045 Corbin Ave
Apt 301
Northridge, CA 91324-3361
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Constellation Home Health Services, LLCCCN 553137
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Jul 24, 2018
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
05D2116552Constellation Home Health Services, LLC9045 Corbin Ave Ste 301, Northridge, CA 91324Certificate of waiverJul 27, 2028

National Provider Directory

National Provider Directory

Locations

9045 Corbin Ave
Ste 301
Northridge, CA 91324
Phone (818) 399-6984

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Warren D Calonzo Individual 5% Or Greater Direct Ownership Interest Feb 4, 2016 12.5%
Robert M Santos Individual 5% Or Greater Direct Ownership Interest Feb 4, 2016 12.5%
Edison G Yutuc Individual 5% Or Greater Direct Ownership Interest Feb 4, 2016 12.5%
Zenedie Y Calonzo Individual 5% Or Greater Direct Ownership Interest Feb 4, 2016 12.5%
Corporate DirectorAdministrator Managing Member 12 Feb 4, 2016 25%
W-2 Managing EmployeeAdministrator Managing Member 12 Feb 4, 2016 25%
Eduardo G Yutuc Individual 5% Or Greater Direct Ownership Interest Feb 4, 2016 12.5%
Corporate DirectorManaging Member, DPCS Designee 1 Feb 4, 2016 25%
W-2 Managing EmployeeManaging Member DPCS Designee 12 Feb 7, 2016 25%
Edzen Y Santos Individual 5% Or Greater Direct Ownership Interest Feb 4, 2016 12.5%
Corporate DirectorManaging Member DPCS 12.5 Owner Feb 4, 2016 25%
W-2 Managing EmployeeManaging Member DPCS 12.5 Owner Feb 4, 2016 25%
Kristina S Yutuc Individual 5% Or Greater Direct Ownership Interest Feb 4, 2016 12.5%
Rhia a Yutuc Individual 5% Or Greater Direct Ownership Interest Feb 4, 2016 12.5%

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1740649045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9045 CORBIN AVE",
            "address_2": "SUITE 301",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243300",
            "telephone_number": "818-399-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9045 CORBIN AVE",
            "address_2": "SUITE 301",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243300",
            "telephone_number": "818-399-6984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSTELLATION HOME HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "CALONZO",
        "authorized_official_first_name": "ZENEDIE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "818-399-6984"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.