Colorado River Home Health

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

COLORADO RIVER HOME HEALTH

Practice address

1406 Bailey Ave Ste H
Needles, CA 92363-3115

Phone

(909) 278-8343

Fax

(909) 498-8790

NPI assigned

Jul 30, 2018

Organization subpart

No

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

Authorized official

Name

Anahit Khachatryan

Title

Ceo

Phone

(909) 278-8343

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757166

Legal name

COLORADO RIVER HOME HEALTH

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 10, 2022

Last certification

Jun 10, 2022

Organization structure

CorporationProprietary

Enrollment address

9003 Reseda Blvd
Ste 208
Northridge, CA 91324-3965

Listed as

Colorado River Home HealthCCN 757166

Overall star rating

1 of 5

Ownership

-

Certified

Jun 10, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Larry P Vigilia

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1629275474

  Corporate Director

  CMS ownership

Practitioners 1

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

• Charles E Hanson, PH.D.

  • Clinical Psychologist
  • Northridge, CA
  • NPI 1851443295
  NPD (past)

Affiliated clinicians 3

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

• Mark A Folmsbee, D.O.

  • General Practice Physician
  • San Fernando, CA
  • NPI 1427393123

  Home health agency

  Care Compare affiliation
• Talato Kabore

  • Family Nurse Practitioner
  • Glendora, CA
  • NPI 1396349395

  Home health agency

  Care Compare affiliation
• Sonja Angelique Mann

  • Family Medicine Physician
  • Mohave Valley, AZ
  • NPI 1821674839

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532908800000",
    "number": "1891273181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 BAILEY AVE STE H",
            "city": "NEEDLES",
            "state": "CA",
            "postal_code": "923633115",
            "telephone_number": "909-278-8343",
            "fax_number": "909-498-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 BAILEY AVE STE H",
            "city": "NEEDLES",
            "state": "CA",
            "postal_code": "923633115",
            "telephone_number": "909-278-8343",
            "fax_number": "909-498-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO RIVER HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A",
        "authorized_official_last_name": "KHACHATRYAN",
        "authorized_official_first_name": "ANAHIT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-278-8343"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billet Adhc Inc Needles
• Ian Anthony Butler, D.O.
• Camdin D Classen
• Michelle R. Chavez
• Rhonda Iddins Clark, FNP
• Community Healthcare Partner, Inc
• Community Healthcare Partner, Inc
• Community Healthcare Partner, Inc.
• Community Healthcare Partner, Inc.
• Community Healthcare Partner, Inc.

• Home Health Agency in Needles, CA
• Providers in Needles, 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 Jul 30, 2018; 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.