Jourdanton Home Care Services, LLC
Organization Active NPI Home Health Agency · Jourdanton, TX
NPI 1003899485 · NPPES record last updated Oct 4, 2024
Key facts
- NPI
- 1003899485
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 012459 (TX)
- Legal business name
- JOURDANTON HOME CARE SERVICES, LLC
- Practice address
- 1907 E State Highway 97 Ste 230
Jourdanton, TX 78026-1534 - Phone
- (830) 281-8136
- Fax
- (830) 281-8751
- NPI assigned
- Nov 21, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Joshua L. Proffitt
- Title
- President
- Phone
- (337) 233-1307
Facilities with the same owner 111
Affiliated clinicians 23
-
Laura S. Allen, M.D.
-
Samer Arab, MD
-
Abimbola Michael Banjo, M.D.,
-
Rachel R Dockery, MD
-
Effiok Ekpenyong, MD
-
Oscar Garza, M.D.
-
William Glen Johnson, FNP-BC
-
Farbod Malek, MD
-
Fnu Rajlakshmi, M.D.
-
Diki Ann Reyes, FNP
-
Joel Saldana, MD
-
Brandy Ree Schjang, APRN, FNP-C
-
Danielle Stockhorst, FNP
-
Gabriel Tarango, D.O.
-
Will Donn Thompson, MPAS, PA-C
-
Zachary Robert Windrow, M.D.
-
Michele Lisette Woodford, PHYSICIAN ASSISTANT
-
Benjamin Scott Zertuche, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Elite Home Health
- Overall star rating
- ★★★★☆ 4 of 5
- Ownership
- Proprietary
- Certified
- Dec 9, 1987
- Medicare certification status
- Active
- Services
- Nursing, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0499002 | Jourdanton Home Care Services LLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Home health agency certification: CCN 677127
- Legal name
- JOURDANTON HOME CARE SERVICES, LLC
- Doing business as
- ELITE HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 9, 1987
- Last certification
- Sep 16, 2021
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Aug 19, 2008 in DE
- Enrollment address
- 1907 Hwy 97 East
Suite 230
Jourdanton, TX 78026-1538
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Unitedhealth Group Incorporated |
5% Or Greater Indirect Ownership Interest | Feb 22, 2023 | 100% |
| Kimberly Barecky |
W-2 Managing Employee |
Apr 22, 2024 | |
| Marcus Donavon Macip |
Corporate Officer |
Feb 22, 2023 | |
| Kimberly Seymour |
Corporate Officer |
Feb 22, 2023 | |
| Afam Holding Co LLC |
5% Or Greater Direct Ownership Interest | Mar 1, 2019 | 100% |
| Wendy S Daigle |
Corporate Director |
Oct 1, 2022 | |
| LHC Group Inc |
5% Or Greater Indirect Ownership Interest | Apr 1, 2018 | 100% |
| Operational/Managerial Control | Mar 1, 2019 | ||
| Joshua Lee Proffitt |
Corporate Officer |
Dec 31, 2019 | |
| Almost Family, Inc. |
5% Or Greater Indirect Ownership Interest | Mar 1, 2019 | 100% |
| National Health Industries, Inc. |
5% Or Greater Indirect Ownership Interest | Mar 1, 2019 | 80% |
| Afam Sub I LLC |
5% Or Greater Indirect Ownership Interest | Mar 1, 2019 | 20% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101108000594 | TX | Part a Provider - Home Health Agency | 4385839067 | Practice locations: Jourdanton, TX |
National Provider Directory
Locations
1907 E Highway 97
Ste 230
Pleasanton, TX 78064
1416 W Oaklawn Rd
Ste A
Pleasanton, TX 78064
Phone (830) 281-8136
Networks
- devoted network organization-29f43891-2cde-4604-ab6a-baa4d2061a18
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 012459 | TX | Yes |
Addresses
Primary practice location
1907 E State Highway 97 Ste 230
Jourdanton, TX 78026-1534
Mailing address
PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HH9806 | Other | TX | BCBS |
| 280066601 | Medicaid | TX |
Other names
- Elite Home Health
Other providers in Jourdanton, TX
- Teri Grubbs
- Hennessey Inpatient Services PLLC
- Jennifer R Iruegas
- William Glen Johnson
- Jourdanton Comunity Cancer Center
- Jourdanton Hospital Corporation
- Jourdanton Hospital Corporation
- Jourdanton Hospital Corporation
- Jourdanton Hospital Corporation
- Jourdanton Nursing and Rehab Center LLC
All providers in Jourdanton, TX · Home Health Agency in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.