Grapevine Home Health Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

550000797 Issued in CA

Legal business name

GRAPEVINE HOME HEALTH SERVICES, INC.

Practice address

8459 White Oak Ave
Suite 103
Rancho Cucamonga, CA 91730-3872

Phone

(909) 483-6505

Fax

(909) 944-3250

NPI assigned

Aug 27, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Eddie D Ruiz

Title

Cfo

Phone

(909) 483-6505

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 059182

Legal name

GRAPEVINE HOME HEALTH SERVICES, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 18, 2010

Last certification

Feb 19, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Feb 1, 2006 in CA

Enrollment address

462 Corona Mall
Ste 101
Corona, CA 92879-1455

Listed as

Grapevine Home Health Services IncCCN 059182

Ownership

Proprietary

Certified

Mar 18, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

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

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393459200000",
    "number": "1174957088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8459 WHITE OAK AVE",
            "address_2": "SUITE 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303872",
            "telephone_number": "909-483-6505",
            "fax_number": "909-944-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8459 WHITE OAK AVE",
            "address_2": "SUITE 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303872",
            "telephone_number": "909-483-6505",
            "fax_number": "909-944-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAPEVINE HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-27",
        "last_updated": "2014-02-27",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "909-483-6505",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "550000797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keylaunie Graham Donato
• Marissa Granado
• Daisy Granda-Gadea
• Eliza Ajero Granflor, ACNP-BC
• Olga Elena Granillo, LCSW
• Grapevine Home Health Services, Inc.
• Lisa K Grater
• Amy Lynn Graves
• Cadisha Alexa Gravesande, LMFT
• Hazel Gray

• Home Health Agency in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.