=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356983472
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIFESTAR HOME HEALTH CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/09/2019
-----------------------------------------------------
Last Update Date | 11/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20501 VENTURA BLVD STE 217
-----------------------------------------------------
City | WOODLAND HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91364-6400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-607-6077
-----------------------------------------------------
Fax | 424-345-2888
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20501 VENTURA BLVD STE 217
-----------------------------------------------------
City | WOODLAND HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91364-6400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-607-6077
-----------------------------------------------------
Fax | 424-345-2888
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. DANIEL GOLCHIAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 800-607-6077
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------