Organization Active NPI

Advanced Home Health Care Inc

  • Home Health Agency
  • San Diego, CA
National Provider Identifier
1922575760
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ADVANCED HOME HEALTH CARE INC
Practice address
4901 Morena Blvd Ste 121
San Diego, CA 92117-3556
Phone
(619) 822-1882
Fax
(619) 822-1262
NPI assigned
Oct 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Authorized official

Name
Benjamin LongstreetNPI 1518380237
Title
Ceo
Phone
(619) 822-1882

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4901 Morena Blvd Ste 121
San Diego, CA 92117-3556

Mailing address

4901 Morena Blvd Ste 121
San Diego, CA 92117-3556
Phone (619) 822-1882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200116001775 CA Part A Provider - Home Health Agency 7911332135 Practice locations: Burbank, CA

Home health agency certification: CCN 559445

Legal name
ADVANCED HOME HEALTH CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 17, 2021
Last certification
Feb 17, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 23, 2018 in CA
Enrollment address
269 W Alameda Ave
Ste E
Burbank, CA 91502-3302

Care Compare: Home health agency

Medicare Care Compare
Listed as
Advanced Home Health Care IncCCN 559445
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Feb 17, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
05D2160168Advanced Home Health Care269 W Alameda Avenue Suite E, Burbank, CA 91502Certificate of waiverJan 6, 2027

National Provider Directory

National Provider Directory

Locations

269 W Alameda Ave
Ste E
Burbank, CA 91502
Phone (747) 477-1578

4901 Morena Blvd
Ste 121
San Diego, CA 92117
Phone (619) 822-1882

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
Vrezh Arubyan Individual 5% Or Greater Direct Ownership InterestCeo Apr 23, 2018 100%
Corporate OfficerCeo Apr 23, 2018 100%
Corporate DirectorCeo Apr 23, 2018 100%
W-2 Managing EmployeeCeo Apr 23, 2018 100%
Operational/Managerial ControlCeo Apr 23, 2018 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": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1922575760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 MORENA BLVD STE 121",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173556",
            "telephone_number": "619-822-1882",
            "fax_number": "747-477-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 MORENA BLVD STE 121",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173556",
            "telephone_number": "619-822-1882",
            "fax_number": "619-822-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "LONGSTREET",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-822-1882"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.