Great Life Home Health Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GREAT LIFE HOME HEALTH INC

Practice address

15720 Ventura Blvd Ste 608
Encino, CA 91436-4732

Phone

(818) 797-5293

NPI assigned

May 9, 2021

Organization subpart

No

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

Authorized official

Name

Karine Simonyan

Title

Ceo

Phone

(818) 797-5293

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757327

Legal name

GREAT LIFE HOME HEALTH INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 8, 2023

Last certification

Apr 12, 2023

Organization structure

CorporationProprietary

Incorporated

Apr 26, 2021 in CA

Enrollment address

15720 Ventura Blvd
Ste 608
Encino, CA 91436-4732

Listed as

Great Life Home Health Inc.CCN 757327

Overall star rating

1.5 of 5

Ownership

-

Certified

May 8, 2023

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

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

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Hani Adiep Benyamin-Ajaipi

  • Internal Medicine Physician
  • Cypress, CA
  • NPI 1770783896

  Home health agency

  Care Compare affiliation
• Richard Keech, M.D.

  • Family Medicine Physician
  • Huntington Park, CA
  • NPI 1487748364

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1620518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646438400000",
    "number": "1851975585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15720 VENTURA BLVD STE 608",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364732",
            "telephone_number": "818-797-5293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15720 VENTURA BLVD STE 608",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364732",
            "telephone_number": "818-797-5293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LIFE HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-09",
        "last_updated": "2022-03-05",
        "certification_date": "2022-03-05",
        "status": "A",
        "authorized_official_last_name": "SIMONYAN",
        "authorized_official_first_name": "KARINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-797-5293"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tooraj Todd Gravori, M.D.
• Azzizi Gray
• Great Beginnings Surgery Center LLC
• Great Home Health Care Inc
• Great Life Home Care Inc
• Greater San Gabriel Valley Physicians
• Green Heart Therapy Inc
• Debra Lynn Green, LMFT
• Gary Wayne Green, DDS
• Larry H. Green, MD

• Home Health Agency in Encino, CA
• Providers in Encino, 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 Mar 5, 2022; 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.