Legacy Home Health Service Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LEGACY HOME HEALTH SERVICE INC

Practice address

10201 Riverside Dr Ste 202
Toluca Lake, CA 91602-2538

Phone

(747) 900-9263

NPI assigned

Sep 28, 2020

Organization subpart

No

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

Authorized official

Name

Bagrat Aleksanyan

Title

Ceo

Phone

(747) 900-9263

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757039

Legal name

LEGACY HOME HEALTH SERVICE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 3, 2022

Last certification

Aug 3, 2022

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Enrollment address

10201 Riverside Dr
Ste 202
Toluca Lake, CA 91602-2538

Listed as

Legacy Home Health Service, IncCCN 757039

Overall star rating

3.5 of 5

Ownership

Proprietary

Certified

Aug 3, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rea Jane Gonzales Padua, OTRP, OTR/L

  • Occupational Therapist
  • Irvine, CA
  • NPI 1871817254
  NPD
• Anthony Corleone Yedigaryan

  • Counselor
  • Toluca Lake, CA
  • NPI 1669113585
  NPD

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1801403498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 RIVERSIDE DR STE 202",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022538",
            "telephone_number": "747-900-9263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 RIVERSIDE DR STE 202",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022538",
            "telephone_number": "747-900-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HOME HEALTH SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "ALEKSANYAN",
        "authorized_official_first_name": "BAGRAT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-900-9263"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark M. Kosker, D.C.
• Danielle Kouri, LMFT
• Jacqueline Ksajikian, FNP
• Lawernce S Toomin & Mark R Bieber
• Amanda Renee Layman, PMHNP
• Jeana G. Libed, DPM
• Limbic Medical
• Nicholas Robert Lombardo
• Aleksandr V Lukoff, CMI, CORECHI
• Minh Q Mach, M.D.

• Home Health Agency in Toluca Lake, CA
• Providers in Toluca Lake, 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 Sep 28, 2020; 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.