Organization Active NPI

Supreme Home Care Services Inc

  • Home Health Agency
  • Glendale, CA
National Provider Identifier
1871193169
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SUPREME HOME CARE SERVICES INC
Practice address
100 N Brand Blvd Ste 416
Glendale, CA 91203-2614
Phone
(818) 858-9171
NPI assigned
Oct 27, 2020
Organization subpart
Yes
Parent organization
JOYFUL HEAVEN INVESTMENTS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Sahak Sahakyan
Title
Ceo
Phone
(818) 858-9171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

100 N Brand Blvd Ste 416
Glendale, CA 91203-2614

Mailing address

100 N Brand Blvd Ste 416
Glendale, CA 91203-2614
Phone (818) 858-9171

Other practice location 1

4119 W Burbank Blvd Ste 182
Burbank, CA 91505-2122
Phone (818) 395-4141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201224000028 CA Part A Provider - Home Health Agency 5294147856 Practice locations: Glendale, CA

Home health agency certification: CCN 757154

Legal name
SUPREME HOME CARE SERVICES INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 23, 2022
Last certification
Aug 23, 2022
Organization structure
CorporationProprietary
Incorporated
Aug 13, 2020 in CA
Enrollment address
100 N Brand Blvd
Ste 416
Glendale, CA 91203-2614

Care Compare: Home health agency

Medicare Care Compare
Listed as
Supreme Home Care Services, Inc.CCN 757154 · All quality measures
Overall star rating
5 of 5
Ownership
-
Certified
Aug 23, 2022
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2308558Supreme Home Care Services, Inc100 N Brand Blvd Ste 416, Glendale, CA 91203Certificate of waiverJul 29, 2026

National Provider Directory

National Provider Directory

Locations

4119 W Burbank Blvd
Ste 182
Burbank, CA 91505
Phone (818) 395-4141

100 N Brand Blvd
Ste 416
Glendale, CA 91203
Phone (818) 395-4141

Ownership & related parties

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.

NameRoleSinceShare
Sahak Sahakyan Individual 5% Or Greater Indirect Ownership Interest Aug 13, 2020 100%
Corporate OfficerCeo,President,Cfo,Secretary Aug 13, 2020
Corporate DirectorCeo,President,Cfo,Secretary Aug 13, 2020
W-2 Managing EmployeeCeo,President,Cfo,Secretary Aug 13, 2020
Joyful Heaven Investments Inc Organization, Van Nuys, CA Corporation 5% Or Greater Direct Ownership Interest Aug 31, 2020 100%

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1871193169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N BRAND BLVD STE 416",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032614",
            "telephone_number": "818-858-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BRAND BLVD STE 416",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032614",
            "telephone_number": "818-858-9171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4119 W Burbank Blvd Ste 182",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "CA",
            "postal_code": "915052122",
            "country_code": "US",
            "telephone_number": "818-395-4141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUPREME HOME CARE SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOYFUL HEAVEN INVESTMENTS, INC",
        "enumeration_date": "2020-10-27",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "SAHAKYAN",
        "authorized_official_first_name": "SAHAK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-858-9171"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.