Ivystone Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

980001038 Issued in CA

Legal business name

IVYSTONE HEALTHCARE LLC

Doing business as

CareMax Home Health

Practice address

17050 Chatsworth St Ste 210
Granada Hills, CA 91344-5891

Phone

(818) 363-1500

Fax

(818) 363-6600

NPI assigned

Oct 20, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Darlyn Grace Bano Gata, RN

Title

Administrator

Phone

(805) 416-9266

Specialties & licenses 1

Addresses

Other names 1

• CareMax Home Health Doing business as

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1962806927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17050 CHATSWORTH ST STE 210",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913445891",
            "telephone_number": "818-363-1500",
            "fax_number": "818-363-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17050 CHATSWORTH ST STE 210",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913445891",
            "telephone_number": "818-363-1500",
            "fax_number": "818-363-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVYSTONE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "GATA",
        "authorized_official_first_name": "DARLYN GRACE",
        "authorized_official_middle_name": "BANO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "805-416-9266",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareMax Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Granada Hills, CA
• Providers in Granada Hills, 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 Oct 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.