Organization Active NPI

Elite Home Health Group Inc

  • Home Health Agency
  • Pasadena, CA
National Provider Identifier
1962053496
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ELITE HOME HEALTH GROUP INC
Practice address
232 N Lake Ave Ste 215
Pasadena, CA 91101-1862
Phone
(626) 349-6002
NPI assigned
Sep 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Authorized official

Name
Artur Mnatsakanyan
Title
Ceo
Phone
(626) 349-6002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

232 N Lake Ave Ste 215
Pasadena, CA 91101-1862

Mailing address

232 N Lake Ave Ste 215
Pasadena, CA 91101-1862
Phone (626) 349-6002

Other identifiers 1

IdentifierTypeStateIssuer
1MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210111002314 CA Part A Provider - Home Health Agency 0648683771 Practice locations: Los Angeles, CA

Home health agency certification: CCN 559565

Legal name
ELITE HOME HEALTH GROUP INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 30, 2021
Last certification
Mar 30, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 30, 2020 in CA
Enrollment address
2829 N San Fernando Rd
Ste 201
Los Angeles, CA 90065-1344

Care Compare: Home health agency

Medicare Care Compare
Listed as
Elite Home Health GroupCCN 559565
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Mar 30, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

2829 N San Fernando Rd
Ste 201
Los Angeles, CA 90065
Phone (626) 349-6002

232 N Lake Ave
Ste 215
Pasadena, CA 91101
Phone (626) 349-6002

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
Artur Mnatsakanyan Individual 5% Or Greater Direct Ownership Interest Apr 30, 2019 100%
Corporate OfficerCeo Apr 30, 2019 100%
Corporate DirectorCeo Apr 30, 2019 100%
W-2 Managing EmployeeCeo Apr 30, 2019 100%

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1569369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612137600000",
    "number": "1962053496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 N LAKE AVE STE 215",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011862",
            "telephone_number": "626-349-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 N LAKE AVE STE 215",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011862",
            "telephone_number": "626-349-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE HOME HEALTH GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-25",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A",
        "authorized_official_last_name": "MNATSAKANYAN",
        "authorized_official_first_name": "ARTUR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-349-6002"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.