Immaculate Heart of Mary Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

980001114 Issued in CA

Legal business name

IMMACULATE HEART OF MARY HOME HEALTH, INC.

Practice address

14329 Woodruff Avenue, Suite a
Bellflower, CA 90706

Phone

(562) 920-9868

Fax

(562) 867-6860

NPI assigned

Jun 11, 2006

Last updated

Jan 10, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan Go

Title

Administrator

Phone

(562) 920-9868

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083656664. Details of each certification follow.

• CCN 058008 Home health agency · Active · Details

Home health agency certification: CCN 058008

Legal name

IMMACULATE HEART OF MARY HOME HEALTH INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 1, 1997

Last certification

Jul 1, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Enrollment address

14329 Woodruff Ave
Ste a
Bellflower, CA 90706-3260

Listed as

Immaculate Heart of Mary Home Health, IncCCN 058008 · All quality measures

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

May 1, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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 5

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

• Edwin R Alexander, M.D.

  • Internal Medicine Physician
  • Orange, CA
  • NPI 1659315752

  Home health agency

  Care Compare affiliation
• Felix Roa Gaw, M.D.

  • Surgery Physician
  • Anaheim, CA
  • NPI 1144243601

  Home health agency

  Care Compare affiliation
• Willie Henry Goffney Jr., MD

  • Surgical Oncology Physician
  • Long Beach, CA
  • NPI 1679776074

  Home health agency

  Care Compare affiliation
• William J Spak, DPM

  • Foot & Ankle Surgery Podiatrist
  • Anaheim, CA
  • NPI 1922189000

  Home health agency

  Care Compare affiliation
• Stacey Cam Tien, P.A. - C

  • Vascular Surgery Physician
  • Orange, CA
  • NPI 1770583056

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1083656664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14329 WOODRUFF AVENUE, SUITE A",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "90706",
            "telephone_number": "562-920-9868",
            "fax_number": "562-867-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14329 WOODRUFF AVENUE, SUITE A",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "90706",
            "telephone_number": "562-920-9868",
            "fax_number": "562-867-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMACULATE HEART OF MARY HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "GO",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "562-920-9868"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA08008F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Iglesias Wilder
• Amarachi Emmanuella Igwe, PMHNP
• Eric T Ikeda, O.D.
• Jessica Zenaida Ilagan-Avergonzado, D.D.S.
• Patricia Ann Kai Ilejay, FNP-BC
• In Development Inc (InDevelopment Telehealth)
• Inb Transportation
• Independence Home Healthcare, Inc.
• Infinity Medical Trasnportation LLC
• Gladys Dulcimira Inga, MD

• Home Health Agency in Bellflower, CA
• Providers in Bellflower, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.