Organization Active NPI

M&M Advanced Healthcare Inc

  • Home Health Agency
  • Cypress, TX
National Provider Identifier
1184924383
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
M&M ADVANCED HEALTHCARE INC
Practice address
11803 Grant Rd Ste 200
Cypress, TX 77429-4021
Phone
(832) 422-3519
Fax
(832) 422-3524
NPI assigned
Oct 22, 2010
Last updated
Jan 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Authorized official

Name
Soledad Banea
Title
Administrator
Phone
(832) 422-3519

Specialties & licenses 1

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

Addresses

Primary practice location

11803 Grant Rd Ste 200
Cypress, TX 77429-4021

Mailing address

11803 Grant Rd Ste 200
Cypress, TX 77429-4021
Phone (832) 422-3519

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120723000006 TX Part A Provider - Home Health Agency 1557527462 Practice locations: Cypress, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184924383. Details of each certification follow.

Home health agency certification: CCN 679785

Legal name
M&M ADVANCED HEALTHCARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 21, 2008
Last certification
Feb 7, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Oct 1, 2010 in TX
Enrollment address
11803 Grant Rd
Ste 200
Cypress, TX 77429-4021

Care Compare: Home health agency

Medicare Care Compare
Listed as
M & M Advanced Healthcare IncCCN 679785 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
May 21, 2008
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
45D1059488M & M Advanced Healthcare, Inc11803 Grant Road, Suite 200, Cypress, TX 77429Certificate of waiverOct 1, 2026

National Provider Directory

National Provider Directory

Locations

11803 Grant Rd
Ste 200
Cypress, TX 77429
Phone (832) 422-3519

4635 Southwest Fwy
Ste 300
Houston, TX 77027
Phone (281) 558-6006

Ownership & related parties

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.

NameRoleSinceShare
Soledad Banea Individual 5% Or Greater Direct Ownership InterestDirector Jan 1, 2025 33%
Corporate OfficerAdministrator May 1, 2018
Corporate DirectorDirector May 18, 2018 33%
W-2 Managing EmployeeAd; May 1, 2018
Robert S Goan Individual Corporate OfficerAlt Administrator Aug 28, 2018
W-2 Managing EmployeeAlt Administrator Sep 28, 2018
Operational/Managerial ControlAlt Administrator Sep 28, 2018
Manuel Sagullo Individual 5% Or Greater Direct Ownership InterestDirector Apr 10, 2023 30%
Corporate OfficerDirector Jan 1, 2025 67%
Corporate DirectorDirector Jan 1, 2025 67%

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1184924383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11803 GRANT RD STE 200",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294021",
            "telephone_number": "832-422-3519",
            "fax_number": "832-422-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11803 GRANT RD STE 200",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294021",
            "telephone_number": "832-422-3519",
            "fax_number": "832-422-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M&M ADVANCED HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "BANEA",
        "authorized_official_first_name": "SOLEDAD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "832-422-3519"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.