Interim Healthcare San Diego LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

080000395 Issued in CA

Legal business name

INTERIM HEALTHCARE SAN DIEGO LLC

Doing business as

Interim Healthcare San Diego Home Health

Practice address

425 W 5TH Ave
Suite 101
Escondido, CA 92025-4843

Phone

(760) 432-9811

Fax

(760) 739-1366

NPI assigned

Jun 17, 2006

Organization subpart

No

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

Authorized official

Name

Patricia Mary McGillan

Title

General Counsel Chief Compliance of

Phone

(301) 956-5087

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Interim Healthcare San Diego Home Health Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093750747. Details of each certification follow.

• CCN 557418 Home health agency · Active · Details

Home health agency certification: CCN 557418

Legal name

INTERIM HEALTHCARE SAN DIEGO LLC

Doing business as

INTERIM HEALTHCARE SAN DIEGO HOME HEALTH

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 20, 1994

Last certification

Nov 7, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Nov 4, 2020 in CA

Enrollment address

425 W 5TH Ave
Ste 101
Escondido, CA 92025-4843

Listed as

Interim Healthcare San Diego Home HealthCCN 557418 · All quality measures

Ownership

Proprietary

Certified

Jun 20, 1994

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

Locations

All disclosed owners & managing parties 9

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

Facilities with the same owner 4

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

• Oakland Hospice, Inc.

  dba Interim Healthcare Hospice-Sacramento Area

  • Community Based Hospice Care Agency
  • Gold River, CA
  • NPI 1730795071

  Cbi-Gator Holding LLC, Interim Healthcare Branches Holdings Inc, Interim Healthcare Branches Intermediate Inc, Interim Healthcare Branches Parent Inc, Interim Healthcare Branches Topco Inc

  CMS ownership
• Interim Healthcare Hospice, LLC

  dba Holy Family Hospice and Palliative Care of Greater Atlanta

  • Community Based Hospice Care Agency
  • Atlanta, GA
  • NPI 1891494753

  Cbi Gator Acquisitions LLC, Cbi-Gator Holding LLC, Interim Healthcare Branches Holdings Inc, Interim Healthcare Branches Intermediate Inc, Interim Healthcare Branches Parent Inc, Interim Healthcare Branches Topco Inc

  CMS ownership
• Interim Healthcare of Treasure Coast, Inc.

  • Home Health Agency
  • West Palm Beach, FL
  • NPI 1114023678

  Cbi Gator Acquisitions LLC, Cbi-Gator Holding LLC, Interim Healthcare Branches Holdings Inc, Interim Healthcare Branches Intermediate Inc, Interim Healthcare Branches Parent Inc, Interim Healthcare Branches Topco Inc

  CMS ownership
• Interim Healthcare San Jose LLC

  dba Interim Healthcare Hospice of East Louisiana

  • Community Based Hospice Care Agency
  • Mandeville, LA
  • NPI 1962149344

  Cbi Gator Acquisitions LLC, Cbi-Gator Holding LLC, Interim Healthcare Branches Holdings Inc, Interim Healthcare Branches Intermediate Inc, Interim Healthcare Branches Parent Inc, Interim Healthcare Branches Topco Inc

  CMS ownership

Change-of-ownership history 2

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1093750747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W 5TH AVE",
            "address_2": "SUITE 101",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254843",
            "telephone_number": "760-432-9811",
            "fax_number": "760-739-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 5TH AVE",
            "address_2": "SUITE 101",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254843",
            "telephone_number": "760-432-9811",
            "fax_number": "760-739-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HEALTHCARE SAN DIEGO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "MCGILLAN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "GENERAL COUNSEL CHIEF COMPLIANCE OF",
        "authorized_official_telephone_number": "301-956-5087"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "080000395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA57418F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interim Healthcare San Diego Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Escondido, CA
• Providers in Escondido, 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 Oct 17, 2023; 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.