Caring Angels Homecare Agency, Inc.
Organization Active NPI Home Health Agency · Wilmington, DE
NPI 1124598156 · NPPES record last updated Apr 8, 2024
Key facts
- NPI
- 1124598156
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- CARING ANGELS HOMECARE AGENCY, INC.
- 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
- Organization subpart
- No
Authorized official
- Name
- Mari Willis, RN
- Title
- Cno
- Phone
- (216) 970-1189
Owners & managing parties with NPI records 1
-
Kyle R Allen, DO
Change of ownership 1
Facilities with the same owner 7
Medicare Care Compare: Hospice
- Listed as
- Patriot Home Care
- Ownership
- For-Profit
- Certified
- May 26, 2020
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
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
- Corporation · Proprietary
- Incorporated
- in DE
- Enrollment address
- 800 W 4TH St
Ste 303
Wilmington, DE 19801-2044
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Salone Walker |
W-2 Managing Employee |
Jul 5, 2023 | |
| Carering Health LLC |
5% Or Greater Direct Ownership Interest | Jul 7, 2023 | 100% |
| Madison Dearborn Capital Partners VIII-B, L.P. |
Limited Partnership Interest | May 4, 2022 | 46.4% |
| PHC Investments II LLC |
5% Or Greater Indirect Ownership Interest | May 4, 2022 | 100% |
| Kyle Allen |
Corporate Officer |
May 1, 2022 | |
| Corporate Director |
May 4, 2022 | ||
| Ravinder Sandhu |
Corporate Officer |
Feb 13, 2023 | |
| Corporate Director |
Feb 13, 2023 | ||
| MDCP VII-C PHC Splitter LP |
Limited Partnership Interest | May 4, 2022 | 24.09% |
| Dina Ibragimova 2020 Irrevocable Trust |
Other | May 4, 2022 | 6.95% |
| PHC Investments I LLC |
5% Or Greater Indirect Ownership Interest | May 4, 2022 | 100% |
| Brenda Riordan |
Corporate Officer |
Aug 18, 2022 | |
| Corporate Director |
Aug 18, 2022 | ||
| Mark Quinnan |
Corporate Officer |
Feb 13, 2023 | |
| Corporate Director |
Feb 13, 2022 | ||
| Marietta Willis |
Corporate Officer |
May 1, 2022 | |
| Corporate Director |
May 4, 2022 | ||
| Vladimir Matkivski 2020 Irrevocable Trust |
Other | May 4, 2022 | 6.95% |
| Cletus S Guenthner |
Corporate Officer |
May 1, 2022 | |
| Corporate Director |
May 4, 2022 | ||
| Charles Fitch |
Corporate Officer |
Dec 5, 2022 | |
| Corporate Director |
Dec 5, 2022 |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Jul 7, 2023 | Change of Ownership |
Aveanna Hospice |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231114001273 | DE | Part a Provider - Hospice | 9931445517 | Practice locations: Wilmington, DE |
National Provider Directory
Locations
800 W 4th St
Ste 303
Wilmington, DE 19801
Phone (302) 467-3535
1225 N King St
Ste 300
Wilmington, DE 19801
Phone (302) 467-3535
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124598156 | Medicaid | DE |
Other names
- Patriot Home Care
Other providers in Wilmington, DE
- Carepath Supply LLC
- Jenna Carey
- Kaitlyn Bryn Carey
- Rachel Carey
- Carez Primary Clinic LLC
- Caring Hands Phlebotomy Services
- Caring Minds Medical Center LLC
- Caring Minds Wellness Center LLC
- Caritas Healthcare Group
- Jennifer Lynne Carite
All providers in Wilmington, DE · Home Health Agency in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.