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Melo Health Systems LLC

Organization Active NPI Home Health Agency · Las Vegas, NV

NPI 1124577127 · NPPES record last updated Oct 2, 2016

Key facts

NPI
1124577127
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
8612-HHA-0 (NV)
Legal business name
MELO HEALTH SYSTEMS LLC
Practice address
1771 E Flamingo Rd
Suite 119B
Las Vegas, NV 89119-5155
Phone
(702) 217-2676
NPI assigned
Oct 2, 2016
Organization subpart
No

Authorized official

Name
Mr. Allen Patcholo Melo Mendoza
Title
Administrator
Phone
(702) 217-2676

Affiliated clinicians 11

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

Medicare Care Compare: Home health agency

Listed as
Executive Care Home Health CCN 297233
Overall star rating
★★★★☆ 3.5 of 5
Ownership
Proprietary
Certified
Jan 25, 2018
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV

Home health agency certification: CCN 297233

Legal name
MELO HEALTH SYSTEMS LLC
Doing business as
EXECUTIVE CARE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 25, 2018
Last certification
Dec 2, 2020
Ownership / control type
Proprietary
Organization structure
LLC · Proprietary
Incorporated
Oct 16, 2015 in NV
Enrollment address
1771 E Flamingo Rd
Ste 119B
Las Vegas, NV 89119-0839
HHA Branch

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Rizel Abigail Mendoza
Individual 		5% Or Greater Direct Ownership Interest
Member/ Owner		 Oct 16, 2015 16.5%
Joey Albert Mendoza
Individual 		5% Or Greater Direct Ownership Interest Oct 16, 2015 16.5%
Francis Laurence Mendoza
Individual 		5% Or Greater Direct Ownership Interest Oct 16, 2015 16.5%
Allen Patcholo M. Mendoza
Individual 		5% Or Greater Direct Ownership Interest
Administrator/ Managing Owner		 Oct 16, 2015 16.5%
Corporate Officer
Administrator		 Oct 16, 2015 100%
Corporate Director
Director of Professional Services		 Oct 16, 2015 100%
Operational/Managerial Control
Managing Employee		 Oct 16, 2015 100%
Niel Darrell Mendoza
Individual 		5% Or Greater Direct Ownership Interest Oct 16, 2015 16.5%
Elsa Mendoza
Individual 		5% Or Greater Direct Ownership Interest
Member/ Owner		 Oct 16, 2015 17.5%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170905001154 NV Part a Provider - Home Health Agency 5890068357 Practice locations: Las Vegas, NV

National Provider Directory

Locations

1771 E Flamingo Rd
Ste 119B
Las Vegas, NV 89119
Phone (702) 217-2676

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 8612-HHA-0 NV Yes

Addresses

Primary practice location

1771 E Flamingo Rd
Suite 119B
Las Vegas, NV 89119-5155

Mailing address

1771 E Flamingo Rd
Suite 119B
Las Vegas, NV 89119-5155
Phone (702) 217-2676

Other names

  • Executive Care Home Health Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 2, 2016.

{
    "created_epoch": "1475366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475366400000",
    "number": "1124577127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 E FLAMINGO RD",
            "address_2": "SUITE 119B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195155",
            "telephone_number": "702-217-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 E FLAMINGO RD",
            "address_2": "SUITE 119B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195155",
            "telephone_number": "702-217-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELO HEALTH SYSTEMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-02",
        "last_updated": "2016-10-02",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "ALLEN PATCHOLO",
        "authorized_official_middle_name": "MELO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-217-2676",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NV",
            "license": "8612-HHA-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Executive Care Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Home Health Agency in Nevada

Sources for this page

Verify at the official NPI Registry.