NPIMap

Organization Active NPI

St.Agatha Home Health LLC

  • Home Health Agency
  • Henderson, NV
National Provider Identifier
1003440140
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ST.AGATHA HOME HEALTH LLC
Practice address
11145 S Eastern Ave
Henderson, NV 89052-4384
Phone
(702) 473-9001
NPI assigned
Feb 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Authorized official

Name
Mr. Alfred T Esguerra
Title
Asst. Administrator
Phone
(630) 248-7450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

11145 S Eastern Ave
Henderson, NV 89052-4384

Mailing address

11145 S Eastern Ave
Henderson, NV 89052-4384
Phone (630) 248-7450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200611001083 NV Part A Provider - Home Health Agency 9638590011 Practice locations: Henderson, NV

Home health agency certification: CCN 297271

Legal name
ST.AGATHA HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 8, 2021
Last certification
Jan 8, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
11145 S Eastern Ave
Ste 130
Henderson, NV 89052-4392

Care Compare: Home health agency

Medicare Care Compare
Listed as
St Agatha Home Health LLCCCN 297271
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Jan 8, 2021
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
29D2199163St Agatha Home Health LLC11145 S Eastern Ave Ste 130, Henderson, NV 89052Certificate of waiverNov 4, 2026

National Provider Directory

National Provider Directory

Locations

11145 S Eastern Ave
Unit 30
Henderson, NV 89052

11145 S Eastern Ave
Ste 130
Henderson, NV 89052
Phone (702) 473-9001

11145 S Eastern Ave
Henderson, NV 89052
Phone (702) 473-9001

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
Ariel Avila Individual W-2 Managing EmployeeDesignee Mar 1, 2019
Imelda Serrano Individual 5% Or Greater Direct Ownership InterestManaging Partner Dec 31, 2025 33%
Operational/Managerial ControlManaging Partner Dec 31, 2025
Darrin Elliott Larsen Individual 5% Or Greater Direct Ownership InterestManaging Partner Dec 31, 2025 67%

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 14

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582761600000",
    "number": "1003440140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11145 S EASTERN AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524384",
            "telephone_number": "630-248-7450",
            "fax_number": "702-473-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11145 S EASTERN AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524384",
            "telephone_number": "702-473-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST.AGATHA HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A",
        "authorized_official_last_name": "ESGUERRA",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ASST. ADMINISTRATOR",
        "authorized_official_telephone_number": "630-248-7450",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.