Organization Active NPI

Caring Angels Homecare Agency, Inc.

Doing business as Patriot Home Care

  • Home Health Agency
  • Wilmington, DE
National Provider Identifier
1124598156
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CARING ANGELS HOMECARE AGENCY, INC.
Doing business as
Patriot Home Care
Practice address
800 W 4TH St Ste 303
Wilmington, DE 19801-2044
Phone
(302) 467-3535
Fax
(302) 397-8998
NPI assigned
Dec 3, 2018
Last updated
Apr 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Authorized official

Name
Mari Willis, RN
Title
Cno
Phone
(216) 970-1189

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

800 W 4TH St Ste 303
Wilmington, DE 19801-2044

Mailing address

800 W 4TH St Ste 303
Wilmington, DE 19801-2044
Phone (302) 467-3535

Other names 1

  • Patriot Home Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231114001273 DE Part A Provider - Hospice 9931445517 Practice locations: Wilmington, DE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124598156. Details of each certification follow.

Hospice certification: CCN 081513

Legal name
CARING ANGELS HOMECARE AGENCY INC
Doing business as
PATRIOT HOME CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 26, 2020
Last certification
May 26, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
in DE
Enrollment address
800 W 4TH St
Ste 303
Wilmington, DE 19801-2044

Care Compare: Hospice

Medicare Care Compare
Listed as
Patriot Home CareCCN 081513 · All quality measures
Ownership
For-Profit
Certified
May 26, 2020
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

1225 N King St
Ste 300
Wilmington, DE 19801
Phone (302) 467-3535

1324 N King St
Wilmington, DE 19801
Phone (302) 407-3046

800 W 4th St
Ste 303
Wilmington, DE 19801
Phone (302) 467-3535

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Salone Walker Individual W-2 Managing EmployeeVP of Operations/Administrator Jul 5, 2023
Carering Health LLC Organization, Chicago, IL LLC 5% Or Greater Direct Ownership Interest Jul 7, 2023 100%
Madison Dearborn Capital Partners VIII-B, L.P. Organization, Chicago, IL Limited Partnership Interest May 4, 2022 46.4%
PHC Investments II LLC Organization, Chicago, IL LLC 5% Or Greater Indirect Ownership Interest May 4, 2022 100%
Kyle Allen Individual Corporate OfficerChief Medical Officer May 1, 2022
Corporate DirectorChief Medical Officer May 4, 2022
Ravinder Sandhu Individual Corporate OfficerChief Administrative Officer Feb 13, 2023
Corporate DirectorChief Administrative Officer Feb 13, 2023
MDCP VII-C PHC Splitter LP Organization, Chicago, IL Limited Partnership Interest May 4, 2022 24.09%
Dina Ibragimova 2020 Irrevocable Trust Organization, Panama City Beach, FL Other May 4, 2022 6.95%
PHC Investments I LLC Organization, Chicago, IL LLC 5% Or Greater Indirect Ownership Interest May 4, 2022 100%
Brenda Riordan Individual Corporate OfficerChief Operating Officer Aug 18, 2022
Corporate DirectorChief Operating Officer Aug 18, 2022
Mark Quinnan Individual Corporate OfficerChief Financial Officer Feb 13, 2023
Corporate DirectorChief Financial Officer Feb 13, 2022
Marietta Willis Individual Corporate OfficerChief Compliance Officer/Chief N May 1, 2022
Corporate DirectorChief Compliance Officer/Chief N May 4, 2022
Vladimir Matkivski 2020 Irrevocable Trust Organization, Sunny Isles Beach, FL Other May 4, 2022 6.95%
Cletus S Guenthner Individual Corporate OfficerChief Executive Officer May 1, 2022
Corporate DirectorChief Executive Officer May 4, 2022
Charles Fitch Individual Corporate OfficerChief Information Officer Dec 5, 2022
Corporate DirectorChief Information Officer Dec 5, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 7

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

Change-of-ownership history 1

DateEventCounterparty
Jul 7, 2023 Change of OwnershipThis provider was the buyer Aveanna HospiceCCN 081513, DE, NPI 1093358798

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1124598156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W 4TH ST STE 303",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198012044",
            "telephone_number": "302-467-3535",
            "fax_number": "302-397-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 4TH ST STE 303",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198012044",
            "telephone_number": "302-467-3535",
            "fax_number": "302-397-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARING ANGELS HOMECARE AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-03",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "MARI",
        "authorized_official_title_or_position": "CNO",
        "authorized_official_telephone_number": "216-970-1189",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patriot Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.