Glennwood Enterprises, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

004870 Issued in TX

Legal business name

GLENNWOOD ENTERPRISES, INC

Doing business as

Heritage HomeCare

Practice address

402 W Wheatland Rd
Suite 170
Duncanville, TX 75116-4600

Phone

(972) 283-8124

NPI assigned

Nov 8, 2006

Last updated

Jun 18, 2008By 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

Starla Ann Timberlake

Title

Assistant Administrator

Phone

(972) 283-8124

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heritage HomeCare Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093885212. Details of each certification follow.

• CCN 459027 Home health agency · Active · Details

Home health agency certification: CCN 459027

Legal name

GLENNWOOD ENTERPRISES, INC

Doing business as

HERITAGE HOMECARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 4, 1996

Last certification

Nov 19, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Enrollment address

505 S 9TH St
Midlothian, TX 76065-3503

Listed as

Heritage HomecareCCN 459027 · All quality measures

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

Dec 4, 1996

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.

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.

• Pamela Kay Chapman, PHD, FNP

  • Family Nurse Practitioner
  • Desoto, TX
  • NPI 1821247594
  NPD

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1093885212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W WHEATLAND RD",
            "address_2": "SUITE 170",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164600",
            "telephone_number": "972-283-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W WHEATLAND RD",
            "address_2": "SUITE 170",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164600",
            "telephone_number": "972-283-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENNWOOD ENTERPRISES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "TIMBERLAKE",
        "authorized_official_first_name": "STARLA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "972-283-8124"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "004870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024180401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage HomeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ann Wanjiru Gathura, BCBA
• Diane Barnes Gawedzinski, L.P.C.
• Geneye Inc. (Duncanville Eye Association and/or Duncanville Optical)
• Helen D Gipson, DPM
• GLC Wellness Center Texas LLC
• Glory Able Home Healthcare Inc (Savior Home Health Inc)
• Glory Financial Services (Glory Decorations & Party Suppliy)
• Ebony Goggins
• Golden Gate Adult Day Care (Envision Diagnostic Ultrasound)
• Golden Roots Wellness Group Inc (Golden Roots Meals)

• Home Health Agency in Duncanville, TX
• Providers in Duncanville, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.