NPIMap

Organization Active NPI

Care Provider Home Health, Inc.

  • Home Health Agency
  • Simi Valley, CA
National Provider Identifier
1144437641
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CARE PROVIDER HOME HEALTH, INC.
Practice address
2775 Tapo St Ste 101
Simi Valley, CA 93063-0467
Phone
(805) 582-9389
Fax
(805) 582-0632
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Authorized official

Name
Beberlina O Perrine
Title
Ceo
Phone
(805) 582-9389

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X CA Primary

Addresses

Primary practice location

2775 Tapo St Ste 101
Simi Valley, CA 93063-0467

Mailing address

2775 Tapo St Ste 101
Simi Valley, CA 93063-0467
Phone (805) 582-9389

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070810000788 CA Part A Provider - Home Health Agency 1052402658 Practice locations: Simi Valley, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144437641. Details of each certification follow.

Home health agency certification: CCN 059027

Legal name
CARE PROVIDER HOME HEALTH, INC.
Doing business as
A FLYING EAGLE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 10, 2009
Last certification
Apr 6, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 13, 2007 in CA
Enrollment address
2775 Tapo St
Ste 101
Simi Valley, CA 93063-0467

Care Compare: Home health agency

Medicare Care Compare
Listed as
A Flying Eagle Home HealthCCN 059027 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Apr 10, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
05D1072531Care Provider Home Health Inc2775 Tapo St, #101, Simi Valley, CA 93063Certificate of waiverAug 16, 2027

National Provider Directory

National Provider Directory

Locations

5775 E Los Angeles Ave
Ste 127
Simi Valley, CA 93063
Phone (805) 582-9389

5775 E Los Angeles Ave
Ste 100
Simi Valley, CA 93063
Phone (805) 582-9389

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Amir P Parvinchiha Individual Contracted Managing EmployeeMedical Director May 15, 2017 50%
Rowena Pinlac Laban Individual W-2 Managing EmployeeDirector of Patient Care Service Mar 2, 2022 10%
Georgina M Ramos Individual W-2 Managing EmployeeDirector of Patient Care Service Oct 1, 2018 50%
Beberlina O Perrine Individual 5% Or Greater Direct Ownership InterestCeo Aug 1, 2007 100%
Corporate OfficerCeo Apr 13, 2007 100%
Corporate DirectorCorporate Director Board Member Aug 1, 2007 100%
W-2 Managing EmployeeAdministrator Aug 1, 2007 100%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 11

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

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1144437641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 TAPO ST STE 101",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930630467",
            "telephone_number": "805-582-9389",
            "fax_number": "805-582-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 TAPO ST STE 101",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930630467",
            "telephone_number": "805-582-9389",
            "fax_number": "805-582-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE PROVIDER HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "PERRINE",
        "authorized_official_first_name": "BEBERLINA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-582-9389"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.