NPIMap

Organization Active NPI

CC Home Health Lubbock LLC

  • Home Health Agency
  • Lubbock, TX
National Provider Identifier
1023095841
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
00-7152 Issued in TX
Legal business name
CC HOME HEALTH LUBBOCK LLC
Practice address
2118 Broadway St
Lubbock, TX 79401-2913
Phone
(806) 785-7903
Fax
(806) 785-7918
NPI assigned
Dec 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Carmen Santiago
Title
Ceo
Phone
(817) 310-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 00-7152 TX Primary

Addresses

Primary practice location

2118 Broadway St
Lubbock, TX 79401-2913

Mailing address

1110 N Carroll Ave
Southlake, TX 76092-5306
Phone (817) 310-1100

Other identifiers 1

IdentifierTypeStateIssuer
1455586-01MedicaidTX

Other names 1

  • CUIDADO CASERO HOME HEALTH LUBBOCK Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060809000133 TX Part A Provider - Home Health Agency 9830192087 Practice locations: Lubbock, TX

Home health agency certification: CCN 459427

Legal name
CC HOME HEALTH LUBBOCK LLC
Doing business as
CUIDADO CASERO HOME HEALTH LUBBOCK
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 21, 1998
Last certification
Apr 7, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
2118 Broadway
Lubbock, TX 79401-2913

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Cuidado Casero Home Health LubbockCCN 459427
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Oct 21, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
CC Home Health Lubbock LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Carmen Santiago Individual 5% Or Greater Direct Ownership Interest Sep 26, 2007 100%
Corporate OfficerCeo Sep 26, 2007 100%
Corporate Director Sep 26, 2007
W-2 Managing Employee Sep 26, 2007

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1023095841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 N CARROLL AVE",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760925306",
            "telephone_number": "817-310-1100",
            "fax_number": "817-310-1197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 BROADWAY ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794012913",
            "telephone_number": "806-785-7903",
            "fax_number": "806-785-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CC HOME HEALTH LUBBOCK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-310-1100"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "00-7152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455586-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CUIDADO CASERO HOME HEALTH LUBBOCK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.