Active NPI
Nova Vita Home Care, Inc
- Home Health Agency
- Granada Hills, CA
National Provider Identifier
1861075731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- NOVA VITA HOME CARE, INC
- Practice address
- 17029 Chatsworth St Ste 202
Granada Hills, CA 91344-7803 - Phone
- (747) 300-2225
- Fax
- (818) 450-0701
- NPI assigned
- Apr 29, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Vaagn Manucharyan
- Title
- Ceo
- Phone
- (747) 300-2225
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
17029 Chatsworth St Ste 202
Granada Hills, CA 91344-7803
Mailing address
17029 Chatsworth St Ste 202a
Granada Hills, CA 91344-5846
Phone (747) 300-2225
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231211002629 | CA | Part A Provider - Home Health Agency | 8325497720 | Practice locations: Granada Hills, CA |
Home health agency certification: CCN 757687
- Legal name
- NOVA VITA HOME CARE, INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Aug 16, 2024
- Last certification
- Aug 16, 2024
- Organization structure
- Corporation
- Incorporated
- Feb 1, 2021 in CA
- Enrollment address
- 17029 Chatsworth St
Ste 202a
Granada Hills, CA 91344-5846
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Nova Vita Home Care, Inc
- Overall star rating
- Ownership
- -
- Certified
- Aug 16, 2024
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
17029 Chatsworth St
Ste 202A
Granada Hills, CA 91344
Phone (747) 300-2225
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Vaagn Manucharyan | 5% Or Greater Direct Ownership Interest | Feb 1, 2021 | 100% |
| Corporate Officer | Feb 1, 2021 | 100% | |
| Corporate Director | Feb 1, 2021 | 100% | |
| W-2 Managing Employee | Feb 1, 2021 | 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": "1619654400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1728518400000",
"number": "1861075731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17029 CHATSWORTH ST STE 202A",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "913445846",
"telephone_number": "747-300-2225",
"fax_number": "818-450-0701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17029 CHATSWORTH ST STE 202",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "913447803",
"telephone_number": "747-300-2225",
"fax_number": "818-450-0701"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NOVA VITA HOME CARE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-29",
"last_updated": "2024-10-10",
"certification_date": "2024-10-10",
"status": "A",
"authorized_official_last_name": "MANUCHARYAN",
"authorized_official_first_name": "VAAGN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "747-300-2225"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Granada Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.