Supreme Home Health Agency Inc

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

SUPREME HOME HEALTH AGENCY INC

Practice address

28924 Old Town Front St Ste 108
Temecula, CA 92590-2857

Phone

(951) 972-3038

Fax

(951) 541-2658

NPI assigned

Mar 25, 2010

Organization subpart

No

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

Authorized official

Name

Galen Gonzalez

Title

President

Phone

(951) 972-3038

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 059566

Legal name

SUPREME HOME HEALTH AGENCY INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 6, 2013

Last certification

Mar 13, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jul 15, 2009 in CA

Enrollment address

7177 Brockton Ave
Ste 451
Riverside, CA 92506-2635

Listed as

Supreme Home Health Agency IncCCN 059566

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

Mar 6, 2013

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

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.

Affiliated clinicians 3

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

• Mousa Matar, M.D.

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1992116982

  Home health agency

  Care Compare affiliation
• Joel A Pengson, MD

  • Internal Medicine Physician
  • Moreno Valley, CA
  • NPI 1720018237

  Home health agency

  Care Compare affiliation
• Abigail Soto, MD

  • Adult Medicine Physician
  • San Bernardino, CA
  • NPI 1538592506

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269475200000",
    "number": "1073837613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28924 OLD TOWN FRONT ST STE 108",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902857",
            "telephone_number": "951-972-3038",
            "fax_number": "951-541-2658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28924 OLD TOWN FRONT ST STE 108",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902857",
            "telephone_number": "951-972-3038",
            "fax_number": "951-541-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME HOME HEALTH AGENCY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-25",
        "last_updated": "2010-03-25",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "GALEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-972-3038"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summit Home Health Systems
• Rebecca Sun
• Eric Sundquist
• Sunglory Ventures, Inc.
• Sunrise Respiratory Care, Inc.
• Anna Suprise
• Maureen F Sutton, RN
• Katelyn Paige Swafford, RPH
• Anna Swan
• Emily Swanson

• Case Management Agency in Temecula, CA
• Providers in Temecula, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.