Organization Active NPI

Centennial Home Health, Inc.

  • Home Health Agency
  • Redlands, CA
National Provider Identifier
1124600895
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CENTENNIAL HOME HEALTH, INC.
Practice address
101 E Redlands Blvd
Suite 247
Redlands, CA 92373-4775
Phone
(909) 904-0829
NPI assigned
Apr 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Authorized official

Name
Adalbert ZamoraNPI 1275285736
Title
Administrator
Phone
(909) 904-0829

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

101 E Redlands Blvd
Suite 247
Redlands, CA 92373-4775

Mailing address

101 E Redlands Blvd
Suite 247
Redlands, CA 92373-4775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230911000695 CA Part A Provider - Home Health Agency 4587028527 Practice locations: Redlands, CA

Home health agency certification: CCN 758204

Legal name
CENTENNIAL HOME HEALTH, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 7, 2025
Last certification
May 19, 2025
Organization structure
CorporationProprietary
Incorporated
Sep 22, 2020 in CA
Enrollment address
101 E Redlands Blvd
Ste 247
Redlands, CA 92373-4725

Care Compare: Home health agency

Medicare Care Compare
Listed as
Centennial Home Health, Inc.CCN 758204
Ownership
-
Certified
May 7, 2025
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2305021Centennial Home Health, Inc.101 E Redlands Blvd, Ste 247, Redlands, CA 92373Certificate of waiverMay 21, 2028

National Provider Directory

National Provider Directory

Locations

101 E Redlands Blvd
Ste 247
Redlands, CA 92373
Phone (909) 471-8887

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Lailanie Zamora Individual 5% Or Greater Direct Ownership InterestCfo Sep 22, 2020 50%
Corporate OfficerCfo Sep 22, 2020 50%
Corporate DirectorCfo Sep 22, 2020 50%
Operational/Managerial ControlCfo Sep 22, 2020 50%
Adalbert M Zamora Individual 5% Or Greater Direct Ownership Interest Oct 26, 2020 50%
Corporate OfficerCeo Apr 22, 2021 50%
Corporate DirectorDirector Oct 26, 2020 50%
W-2 Managing EmployeeAdministrator / DPCS Jun 1, 2021 50%
Operational/Managerial ControlDirector Oct 26, 2020 50%

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1124600895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E REDLANDS BLVD",
            "address_2": "SUITE 247",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E REDLANDS BLVD",
            "address_2": "SUITE 247",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734775",
            "telephone_number": "909-904-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "ZAMORA",
        "authorized_official_first_name": "ADALBERT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-904-0829"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.