Organization Active NPI

Silverline Home Health

  • Home Health Agency
  • Simi Valley, CA
National Provider Identifier
1962167882
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SILVERLINE HOME HEALTH
Practice address
1720 E Los Angeles Ave Ste 233
Simi Valley, CA 93065-5812
Phone
(805) 288-1353
Fax
(424) 426-3433
NPI assigned
Nov 4, 2021
Last updated
Nov 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Authorized official

Name
Janna Manukyan Bolton
Title
Administrator
Phone
(805) 288-1353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1720 E Los Angeles Ave Ste 233
Simi Valley, CA 93065-5812

Mailing address

1720 E Los Angeles Ave Ste 233
Simi Valley, CA 93065-5812
Phone (805) 288-1353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240517000272 CA Part A Provider - Home Health Agency 9638510993 Practice locations: Simi Valley, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962167882. Details of each certification follow.

Home health agency certification: CCN 757853

Legal name
SILVERLINE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 14, 2025
Last certification
Feb 14, 2025
Organization structure
CorporationProprietary
Incorporated
in CA
Enrollment address
1720 E Los Angeles Ave
Ste 233
Simi Valley, CA 93065-5812

Care Compare: Home health agency

Medicare Care Compare
Listed as
Silverline Home HealthCCN 757853 · All quality measures
Ownership
-
Certified
Feb 14, 2025
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
05D2307691Silverline Home Health1720 E Los Angeles Ave, Ste 233, Simi Valley, CA 93065Certificate of waiverJul 11, 2028

National Provider Directory

National Provider Directory

Locations

1720 E Los Angeles Ave
Ste 233
Simi Valley, CA 93065
Phone (805) 288-1353

Ownership & related parties

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.

NameRoleSinceShare
Mariam Manoukian Individual 5% Or Greater Direct Ownership Interest Aug 16, 2021 33%
Corporate OfficerOwner/Secretary Aug 16, 2021 33%
W-2 Managing EmployeeOwner/Secretary Aug 16, 2021
Janna M Manukyan Individual 5% Or Greater Direct Ownership Interest Aug 16, 2021 34%
Corporate OfficerOwner/ President Aug 16, 2021 34%
W-2 Managing EmployeeOwner/ President Aug 16, 2021 34%
Ani S Karapetyan Individual 5% Or Greater Direct Ownership Interest Aug 16, 2021 33%
Corporate Director Aug 16, 2021 33%

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1635984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635984000000",
    "number": "1962167882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 E LOS ANGELES AVE STE 233",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930655812",
            "telephone_number": "805-288-1353",
            "fax_number": "424-426-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E LOS ANGELES AVE STE 233",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930655812",
            "telephone_number": "805-288-1353",
            "fax_number": "424-426-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVERLINE HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "BOLTON",
        "authorized_official_first_name": "JANNA",
        "authorized_official_middle_name": "MANUKYAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "805-288-1353"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.