Organization Active NPI

Heavenly Host Inc

  • Home Health Agency
  • Mesquite, TX
National Provider Identifier
1093738379
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
HEAVENLY HOST INC
Practice address
536 S Bryan Belt Line Rd
Mesquite, TX 75149-5031
Phone
(972) 289-3800
Fax
(972) 289-3801
NPI assigned
Jul 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Authorized official

Name
Viji AntonyNPI 1669486841
Title
Director
Phone
(972) 289-3800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Personal Care AttendantGroup: 193400000X SINGLE SPECIALTY GROUP 3747P1801X

Addresses

Primary practice location

536 S Bryan Belt Line Rd
Mesquite, TX 75149-5031

Mailing address

536 S Bryan Belt Line Rd
Mesquite, TX 75149-5031
Phone (972) 289-3800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070801000079 TX Part A Provider - Home Health Agency 2567553886 Practice locations: Mesquite, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093738379. Details of each certification follow.

Home health agency certification: CCN 679778

Legal name
HEAVENLY HOST INC
Doing business as
HEAVENLY HOST HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 10, 2008
Last certification
Nov 13, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 20, 2006 in TX
Enrollment address
536 S Bryan Belt Line Road
Mesquite, TX 75149-5031

Care Compare: Home health agency

Medicare Care Compare
Listed as
Heavenly Host Home HealthCCN 679778 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Apr 10, 2008
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
45D1057531Heavenly Host Inc536 S Bryan-Belt Line Road, Mesquite, TX 75149Certificate of waiverAug 14, 2026

National Provider Directory

National Provider Directory

Locations

2033 Military Pkwy
Ste 305C
Mesquite, TX 75149

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
Viji Antony Individual 5% Or Greater Direct Ownership Interest Jun 20, 2016 100%
Corporate OfficerChief Financial Officer Mar 8, 2010
Corporate DirectorPresident Jun 20, 2006
W-2 Managing EmployeeAdministrator Jun 20, 2006
Omana Antony Individual W-2 Managing EmployeeAlternate Supervising Nurse Jul 19, 2006
Sheeba Zachariah Individual W-2 Managing EmployeeAlternate Admin, Supv Nurse Jul 19, 2006

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

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": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1093738379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 S BRYAN BELT LINE RD",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751495031",
            "telephone_number": "972-289-3800",
            "fax_number": "972-289-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 S BRYAN BELT LINE RD",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751495031",
            "telephone_number": "972-289-3800",
            "fax_number": "972-289-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY HOST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "ANTONY",
        "authorized_official_first_name": "VIJI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "972-289-3800"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.