NPIMap

Organization Active NPI

Miracle Home Health Care, Inc.

  • Home Health Agency
  • Los Angeles, CA
National Provider Identifier
1194899138
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
550000736 Issued in CA
Legal business name
MIRACLE HOME HEALTH CARE, INC.
Practice address
5670 Wilshire Blvd
Suite 1600
Los Angeles, CA 90036
Phone
(323) 782-3883
Fax
(323) 782-3883
NPI assigned
Nov 20, 2006
Last updated
May 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Authorized official

Name
Mr. Felix De Guzman, RN
Title
Administrator
Phone
(323) 782-3883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 550000736 CA Primary

Addresses

Primary practice location

5670 Wilshire Blvd
Suite 1600
Los Angeles, CA 90036

Mailing address

5670 Wilshire Blvd
Suite 1600
Los Angeles, CA 90036
Phone (323) 782-3883

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061221000554 CA Part A Provider - Home Health Agency 7719987742 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194899138. Details of each certification follow.

Home health agency certification: CCN 059000

Legal name
MIRACLE HOME HEALTH CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 16, 2008
Last certification
Feb 5, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Oct 6, 2006 in CA
Enrollment address
5670 Wilshire Blvd
Ste 1600
Los Angeles, CA 90036-5659
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Miracle Home Health Care, IncCCN 059000 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Oct 16, 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
05D1084887Miracle Home Health Care, Inc5670 Wilshire Blvd Ste 1600, Los Angeles, CA 90036Certificate of waiverJun 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Miracle Home Health Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

5670 Wilshire Blvd
Ste 1600
Los Angeles, CA 90036
Phone (323) 782-3883

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
Hazel P Aro Individual 5% Or Greater Direct Ownership Interest Oct 2, 2006 50%
Corporate OfficerCorporate Secretary Oct 2, 2006 50%
Corporate DirectorCorporate Secretary Oct 2, 2006 50%
W-2 Managing EmployeeDirector of Patient Care Services Oct 2, 2006 50%
Operational/Managerial ControlCorporate Secretary Oct 2, 2006 50%
Felix F de Guzman Individual 5% Or Greater Direct Ownership InterestCeo, Administrator Oct 2, 2006 50%
Corporate OfficerCeo, Administrator Oct 2, 2006 50%
Corporate DirectorCeo, Administrator Oct 2, 2006 50%
W-2 Managing EmployeeAdministrator Oct 2, 2006 50%
Operational/Managerial ControlCeo, Administrator Oct 2, 2006 50%

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Affiliated clinicians 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526601600000",
    "number": "1194899138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5670 WILSHIRE BLVD",
            "address_2": "SUITE 1600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90036",
            "telephone_number": "323-782-3883",
            "fax_number": "323-782-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5670 WILSHIRE BLVD",
            "address_2": "SUITE 1600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90036",
            "telephone_number": "323-782-3883",
            "fax_number": "323-782-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2018-05-18",
        "status": "A",
        "authorized_official_last_name": "DE GUZMAN",
        "authorized_official_first_name": "FELIX",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-782-3883",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "550000736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.