Serov Home Health LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SEROV HOME HEALTH LLC

Practice address

126 S Jackson St Ste 200
Glendale, CA 91205-4920

Phone

(818) 397-9025

Fax

(818) 937-9025

NPI assigned

Nov 14, 2022

Last updated

Jun 10, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anna Khachikyan

Title

Ceo

Phone

(818) 397-9025

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770291296. Details of each certification follow.

• CCN 758017 Home health agency · Active · Details

Home health agency certification: CCN 758017

Legal name

SEROV HOME HEALTH LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 31, 2025

Last certification

Jul 18, 2025

Organization structure

LLCProprietary

Enrollment address

126 S Jackson St
Ste 200
Glendale, CA 91205-4920
HHA Branch

Listed as

Serov Home Health LLCCCN 758017 · All quality measures

Ownership

-

Certified

Jul 31, 2025

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1770291296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 S JACKSON ST STE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054920",
            "telephone_number": "818-397-9025",
            "fax_number": "818-937-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 S JACKSON ST STE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054920",
            "telephone_number": "818-397-9025",
            "fax_number": "818-937-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEROV HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "KHACHIKYAN",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-397-9025"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Glendale, CA
• Providers in Glendale, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.

Verify at the official NPI Registry.