NPIMap

Organization Active NPI

Livingstone Home Health Services Inc.

  • Home Health Agency
  • Buena Park, CA
National Provider Identifier
1972611846
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
A8730762 Issued in CA
Legal business name
LIVINGSTONE HOME HEALTH SERVICES INC.
Practice address
6301 Beach Blvd
Suite 212
Buena Park, CA 90621-2840
Phone
(714) 994-6329
Fax
(714) 994-6374
NPI assigned
Aug 29, 2006
Last updated
Dec 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Authorized official

Name
Mrs. Ki Sook Lyn, RN
Title
President
Phone
(714) 994-6329

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X A8730762 CA Primary

Addresses

Primary practice location

6301 Beach Blvd
Suite 212
Buena Park, CA 90621-2840

Mailing address

6301 Beach Blvd
Suite 212
Buena Park, CA 90621-2840
Phone (714) 994-6329

Other identifiers 1

IdentifierTypeStateIssuer
HHA07422GMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050705000763 CA Part A Provider - Home Health Agency 2062458615 Practice locations: Buena Park, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972611846. Details of each certification follow.

Home health agency certification: CCN 057422

Legal name
LIVINGSTONE HOME HEALTH SERVICES INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 6, 1993
Last certification
Oct 22, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Nov 22, 1999 in CA
Enrollment address
6301 Beach Blvd
212
Buena Park, CA 90621-4030

Care Compare: Home health agency

Medicare Care Compare
Listed as
Livingstone Home Health Services, IncCCN 057422 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Oct 6, 1993
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
05D0920522Livingstone Home Health Services Inc6301 Beach Blvd Ste 212, Buena Park, CA 90621Certificate of waiverOct 2, 2026

National Provider Directory

National Provider Directory

Locations

6301 Beach Blvd
Ste 212
Buena Park, CA 90621
Phone (714) 994-6329

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Su-Yong Pak Individual Contracted Managing Employee Dec 1, 1999
Ki Sook Lyn Individual 5% Or Greater Direct Ownership InterestOwner Dec 4, 2001 100%
Corporate Director Dec 4, 2001
W-2 Managing Employee Dec 4, 2001

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1972611846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 BEACH BLVD",
            "address_2": "SUITE 212",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212840",
            "telephone_number": "714-994-6329",
            "fax_number": "714-994-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 BEACH BLVD",
            "address_2": "SUITE 212",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212840",
            "telephone_number": "714-994-6329",
            "fax_number": "714-994-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVINGSTONE HOME HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "LYN",
        "authorized_official_first_name": "KI SOOK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-994-6329",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "A8730762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA07422G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

Verify at the official NPI Registry.