Andre F. Henry Medical Enterprise Inc.
Organization Active NPI Home Health Agency · Glendale, CA
NPI 1194894782 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1194894782
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- ANDRE F. HENRY MEDICAL ENTERPRISE INC.
- Practice address
- 331 Arden Ave
Suite 101
Glendale, CA 91203-4059 - Phone
- (818) 241-6470
- Fax
- (818) 241-8124
- NPI assigned
- Nov 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Trudy K Adams
- Title
- Office Manager
- Phone
- (818) 241-6470
Affiliated clinicians 1
-
Elisa C Alvarado, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Rely Able Home Health Care
- Overall star rating
- ★★★★☆ 4 of 5
- Ownership
- Proprietary
- Certified
- Apr 24, 2003
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Home health agency certification: CCN 058177
- Legal name
- ANDRE F. HENRY MEDICAL ENTERPRISE INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 24, 2003
- Last certification
- Feb 26, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Apr 18, 2002 in CA
- Enrollment address
- 331 Arden Ave
Ste 101
Glendale, CA 91203-4023
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Claudel Thamas |
Contracted Managing Employee |
Jun 27, 2003 | |
| Corporate Officer |
Jun 27, 2003 | ||
| Corporate Director |
Jun 27, 2003 | ||
| Other |
Jun 27, 2003 | ||
| Yanick Henry-Edwards |
Corporate Officer |
May 18, 2005 | |
| Corporate Director |
May 18, 2005 | ||
| W-2 Managing Employee | May 18, 2005 | ||
| Other | Aug 17, 2007 | ||
| Patrick Henry |
Corporate Officer |
Jan 1, 2009 | |
| Corporate Director |
Jan 1, 2009 | ||
| W-2 Managing Employee | Jan 1, 2009 | ||
| Marlene Henry |
5% Or Greater Direct Ownership Interest | May 18, 2005 | 100% |
| Corporate Director | May 18, 2005 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101019000000 | CA | Part a Provider - Home Health Agency | 2567417835 | Practice locations: Glendale, CA |
National Provider Directory
Locations
331 Arden Ave
Ste 101
Glendale, CA 91203
Phone (213) 761-4304
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | CA | Yes |
Addresses
Primary practice location
331 Arden Ave
Suite 101
Glendale, CA 91203-4059
Mailing address
331 Arden Ave
Suite 101
Glendale, CA 91203-4059
Phone (818) 241-6470
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HHA08177F | Medicaid | CA |
Other names
- Rely Able Home Health Care
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.