NPIMap

Organization Active NPI

Home Life, LLC

  • Home Health Agency
  • Miami, FL
National Provider Identifier
1033298039
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
HOME LIFE, LLC
Practice address
175 Fontainebleau Blvd.
Suite 1G3
Miami, FL 33172-7018
Phone
(305) 225-3900
Fax
(305) 225-3940
NPI assigned
Nov 2, 2006
Last updated
Apr 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Authorized official

Name
Mr. Jorge Trueba
Title
Administrator
Phone
(305) 225-3900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Home Health Agency 251E00000X FL Primary

Addresses

Primary practice location

175 Fontainebleau Blvd.
Suite 1G3
Miami, FL 33172-7018

Mailing address

175 Fontainebleau Blvd. Suite 1 G 3
Miami, FL 33172-7018
Phone (305) 225-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080423000237 FL Part A Provider - Home Health Agency 5092893602 Practice locations: Miami, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033298039. Details of each certification follow.

Home health agency certification: CCN 109363

Legal name
HOME LIFE, LLC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 20, 2009
Last certification
Apr 22, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
175 Fontainebleau Boulevard
Suite 1 G 3
Miami, FL 33172-4511

Care Compare: Home health agency

Medicare Care Compare
Listed as
Home Life, LLCCCN 109363 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
May 20, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory

Locations

175 Fontainebleau Blvd
Ste 1G3
Miami, FL 33172
Phone (305) 225-3900

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
Jorge Trueba Individual 5% Or Greater Indirect Ownership Interest Mar 10, 2017 50%
Corporate OfficerManager Mar 10, 2017
Carlos Sosa Individual 5% Or Greater Direct Ownership Interest Aug 14, 2015 50%
Corporate DirectorManaging Member Aug 14, 2015 50%
W-2 Managing EmployeeManaging Member Aug 14, 2015 50%
G & J Investing Group Inc Organization, Miami, FL Corporation, For-profit 5% Or Greater Direct Ownership Interest Mar 10, 2017 50%

Practitioners & affiliated clinicians

Affiliated clinicians 6

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

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1033298039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 FONTAINEBLEAU BLVD. SUITE 1 G 3",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331727018",
            "telephone_number": "305-225-3900",
            "fax_number": "305-225-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 FONTAINEBLEAU BLVD.",
            "address_2": "SUITE 1G3",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331727018",
            "telephone_number": "305-225-3900",
            "fax_number": "305-225-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "TRUEBA",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "305-225-3900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.