NPIMap

Organization Active NPI

Professional Home Services, Inc.

  • Home Health Agency
  • Miami Lakes, FL
National Provider Identifier
1073690491
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
209740961 Issued in FL
Legal business name
PROFESSIONAL HOME SERVICES, INC.
Practice address
6001 NW 153Rd St
Suite 152
Miami Lakes, FL 33014-2419
Phone
(305) 827-1211
Fax
(305) 827-1320
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Authorized official

Name
Mrs. Rebeca Nunez Grillo, R.N., B.S.N.
Title
Administrator
Phone
(305) 827-1211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 209740961 FL Primary

Addresses

Primary practice location

6001 NW 153Rd St
Suite 152
Miami Lakes, FL 33014-2419

Mailing address

6001 NW 153Rd St
Suite 152
Miami Lakes, FL 33014-2419
Phone (305) 827-1211

Other identifiers 1

IdentifierTypeStateIssuer
650884700MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120425000268 FL Part A Provider - Home Health Agency 2264349901 Practice locations: Miami Lakes, FL

Home health agency certification: CCN 107793

Legal name
PROFESSIONAL HOME SERVICES, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 19, 2003
Last certification
Jan 7, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
6001 N.W. 153Rd Street
Suite # 152
Miami Lakes, FL 33014-2475
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Professional Home Services, Inc.CCN 107793 · All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Sep 19, 2003
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
10D0925148Professional Home Services Inc6001 NW 153Rd Street Suite 152, Miami Lakes, FL 33014Certificate of waiverFeb 18, 2027

National Provider Directory

National Provider Directory

Locations

6001 NW 153rd St
Ste 152
Miami Lakes, FL 33014
Phone (305) 827-1211

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
Rebecca Grillo Individual 5% Or Greater Direct Ownership Interest Feb 11, 1998 100%
Caroline Alpizar Individual W-2 Managing Employee Nov 28, 2011
Miguel Grillo Individual W-2 Managing Employee Nov 28, 2011

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1073690491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 NW 153RD ST",
            "address_2": "SUITE 152",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142419",
            "telephone_number": "305-827-1211",
            "fax_number": "305-827-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 NW 153RD ST",
            "address_2": "SUITE 152",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142419",
            "telephone_number": "305-827-1211",
            "fax_number": "305-827-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HOME SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "GRILLO",
        "authorized_official_first_name": "REBECA",
        "authorized_official_middle_name": "NUNEZ",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "305-827-1211",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N., B.S.N."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "209740961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "650884700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.