Organization Active NPI

Mission Home Health of San Diego LLC

  • Home Health Agency
  • San Diego, CA
National Provider Identifier
1063726628
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
080000548 Issued in CA
Legal business name
MISSION HOME HEALTH OF SAN DIEGO LLC
Practice address
2365 Northside Dr Ste 100
San Diego, CA 92108-2710
Phone
(619) 757-2700
Fax
(760) 871-0713
NPI assigned
Aug 5, 2010
Last updated
Nov 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Authorized official

Name
Mr. Stephen Murphy
Title
Senior Vice President - Finance
Phone
(888) 871-0766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 080000548 CA Primary

Addresses

Primary practice location

2365 Northside Dr Ste 100
San Diego, CA 92108-2710

Mailing address

2365 Northside Dr Ste 200
San Diego, CA 92108-2720
Phone (888) 871-0766

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101011000819 CA Part A Provider - Home Health Agency 2567654460 Practice locations: Murrieta, CA; San Diego, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063726628. Details of each certification follow.

Home health agency certification: CCN 557711

Legal name
MISSION HOME HEALTH OF SAN DIEGO LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 31, 1996
Last certification
Dec 14, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jun 30, 2009 in CA
Enrollment address
2365 Northside Dr
Ste 100
San Diego, CA 92108-2710

Care Compare: Home health agency

Medicare Care Compare
Listed as
Mission Home Health of San Diego LLCCCN 557711 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
May 31, 1996
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

Locations

25186 Hancock Ave
Ste 320
Murrieta, CA 92562
Phone (951) 461-2800

71703 Highway 111
Ste 1D
Rancho Mirage, CA 92270
Phone (760) 501-1572

71780 San Jacinto Dr
Ste A2
Rancho Mirage, CA 92270
Phone (760) 340-3248

2365 Northside Dr
Ste 100
San Diego, CA 92108
Phone (619) 757-2700

2375 Northside Dr
Ste 150
San Diego, CA 92108
Phone (619) 387-6315

2385 Northside Dr
Ste 200
San Diego, CA 92108
Phone (619) 757-2700

215 S Pacific St
Ste 109
San Marcos, CA 92078
Phone (760) 759-2695

334 Via Vera Cruz
Ste 150
San Marcos, CA 92078
Phone (760) 759-2695

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Mission Healthcare Intermediate Holdings LLC Organization, San Diego, CA LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Sep 4, 2019 100%
TVG Bolt Buyer, LLC Organization, Chicago, IL LLC, For-profit 5% Or Greater Indirect Ownership Interest Aug 1, 2022 47.79%
Mission Healthcare Services, LLC Organization, San Diego, CA LLC, For-profit 5% Or Greater Direct Ownership Interest Mar 29, 2017 100%
Capricorn Healthcare & Special Opportunities II, LP Organization, San Diego, CA 5% Or Greater Indirect Ownership Interest Jun 25, 2024 9.49%
MH Holdings Management Holdco LLC Organization, Chicago, IL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 1, 2022 21.47%
Vistria Fund III (Ft) LP Organization, Chicago, IL For-profit 5% Or Greater Indirect Ownership Interest Aug 1, 2022 15.33%
TVG MH Holdings III (Ft) LP Organization, Chicago, IL Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 1, 2022 15.73%
TVG MH Intermediate Holdings LLC Organization, Chicago, IL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 25, 2020 100%
TVG MH III (Ft) Blocker LLC Organization, Chicago, IL LLC, For-profit 5% Or Greater Indirect Ownership Interest Aug 1, 2022 15.73%
Steve Murphy Individual Corporate OfficerSenior Vice President - Finance Jun 5, 2023
W-2 Managing Employee Jun 5, 2023
TVG MH Holdings LLC Organization, Chicago, IL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 25, 2020 100%
Vistria Fund III LP Organization, Chicago, IL For-profit 5% Or Greater Indirect Ownership Interest Aug 1, 2022 32.05%

Facilities with the same owner 95

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 95

Practitioners & affiliated clinicians

Affiliated clinicians 143

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

View all 143

NPI Registry JSON

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1063726628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 NORTHSIDE DR STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082720",
            "telephone_number": "888-871-0766",
            "fax_number": "866-551-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 NORTHSIDE DR STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082710",
            "telephone_number": "619-757-2700",
            "fax_number": "760-871-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION HOME HEALTH OF SAN DIEGO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT - FINANCE",
        "authorized_official_telephone_number": "888-871-0766",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "080000548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.