Organization Active NPI

Saint George Home Health

  • Home Health Agency
  • Glendale, CA
National Provider Identifier
1750976635
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SAINT GEORGE HOME HEALTH
Practice address
127 S Brand Blvd Ste 218
Glendale, CA 91204-1373
Phone
(818) 369-1167
NPI assigned
Mar 3, 2021
Last updated
Jul 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Authorized official

Name
Hasmik Avetisyan
Title
Ceo
Phone
(818) 369-1167

Specialties & licenses 1

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

Addresses

Primary practice location

127 S Brand Blvd Ste 218
Glendale, CA 91204-1373

Mailing address

127 S Brand Blvd Ste 218
Glendale, CA 91204-1373
Phone (818) 369-1167

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220510000696 CA Part A Provider - Home Health Agency 7618354853 Practice locations: Glendale, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750976635. Details of each certification follow.

Home health agency certification: CCN 753192

Legal name
SAINT GEORGE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 23, 2022
Last certification
Aug 23, 2022
Organization structure
CorporationProprietary
Incorporated
Feb 9, 2021 in CA
Enrollment address
127 S Brand Blvd
Ste 218
Glendale, CA 91204-1373

Care Compare: Home health agency

Medicare Care Compare
Listed as
Saint George Home HealthCCN 753192 · All quality measures
Overall star rating
2.5 of 5
Ownership
-
Certified
Aug 23, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

127 S Brand Blvd
Ste 218
Glendale, CA 91204
Phone (818) 369-1167

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
Hasmik Avetisyan Individual 5% Or Greater Direct Ownership InterestCeo/Cfo/Secretary Jan 5, 2022 100%
Corporate OfficerCeo/Cfo/Secretary Jan 5, 2022 100%
Corporate DirectorCeo/Cfo/Secretary Jan 5, 2022 100%
W-2 Managing EmployeeCeo/Cfo/Secretary Jan 5, 2022 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": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752192000000",
    "number": "1750976635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 S BRAND BLVD STE 218",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041373",
            "telephone_number": "818-369-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S BRAND BLVD STE 218",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041373",
            "telephone_number": "818-369-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT GEORGE HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A",
        "authorized_official_last_name": "AVETISYAN",
        "authorized_official_first_name": "HASMIK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-369-1167"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.