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EVERGREEN HEALTH CARE SERVICES
NPI 1053067397
Home Health in North Hollywood, CA

Active since February 24, 2022CLIA 05D2316237 · Waiver
12444 VICTORY BLVD STE 411-G, NORTH HOLLYWOOD, CA 91606(818) 304-8020(818) 855-8497 Get Directions Write a Review

NPPES record last updated: February 24, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Evergreen Health Care Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN HEALTH CARE SERVICES (NPI 1053067397) is a healthcare organization registered as a home health in North Hollywood, California and active in the NPI registry since February 2022. The organization holds a CLIA Waiver certificate valid through December 30, 2026 and lists Anna Vardanyan, Ceo,cfo,secretary, as its authorized official.

NPPES Registry Identity

NPI1053067397
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameEVERGREEN HEALTH CARE SERVICES
Location Address12444 VICTORY BLVD STE 411-GNorth Hollywood, CA 91606-3199
Mailing Address12444 Victory Blvd Ste 411-gNorth Hollywood, CA 91606-3199 · (818) 304-8020 · Fax (818) 855-8497
Phone(818) 304-8020
Fax(818) 855-8497
Organization SubpartNo
Authorized OfficialAnna VardanyanCeo,cfo,secretary · (818) 304-8020
Enumeration DateFebruary 24, 2022
NPPES CertifiedFebruary 24, 2022
✔ NPI 1053067397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
12444 VICTORY BLVD STE 411-G, North Hollywood, CA 91606
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2316237

Evergreen Health Care Services · North Hollywood, CA
Active · expires Dec 30, 2026
CLIA Number05D2316237
Laboratory TypeHome Health Agency
Certificate Effective DateDecember 31, 2024
Certificate Expiration DateDecember 30, 2026
Laboratory DirectorArmen G. Derian
Laboratory Phone(818) 304-8020
Laboratory LocationEvergreen Health Care Services12444 Victory Blvd, Suite 411-G, North Hollywood, CA 91606
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evergreen Health Care Services's NPI number?

The NPI number for Evergreen Health Care Services is 1053067397. It was assigned to this organization in the NPPES registry on February 24, 2022.

Where is Evergreen Health Care Services located?

Evergreen Health Care Services is located at 12444 Victory Blvd Ste 411-G, North Hollywood, CA 91606. The listed phone number is (818) 304-8020.

What is Evergreen Health Care Services's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Evergreen Health Care Services hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2316237) is associated with this NPI, valid through December 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Evergreen Health Care Services was last updated on February 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.