Organization Active NPI

Nova Vita Home Care, Inc

  • Home Health Agency
  • Granada Hills, CA
National Provider Identifier
1861075731
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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

Updated by the provider on Oct 10, 2024

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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
CorporationProprietary
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, IncCCN 757687 · All quality measures
Overall star rating
3 of 5
Ownership
-
Certified
Aug 16, 2024
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Vaagn Manucharyan Individual 5% Or Greater Direct Ownership InterestCeo Feb 1, 2021 100%
Corporate OfficerCeo Feb 1, 2021 100%
Corporate DirectorCeo Feb 1, 2021 100%
W-2 Managing EmployeeCeo 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

Verify at the official NPI Registry.