NPIMap

Organization Active NPI

Mary'S Help Home Health Services, Inc.

  • Home Health Agency
  • Vallejo, CA
National Provider Identifier
1205929593
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MARY'S HELP HOME HEALTH SERVICES, INC.
Practice address
3469 Tennessee St
Suite 101
Vallejo, CA 94591-5688
Phone
(707) 645-7447
Fax
(707) 645-8929
NPI assigned
Oct 2, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Warren Delfin
Title
President/Administrator
Phone
(650) 581-1359

Affiliated clinicians 36

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

View all 36

Care Compare: Home health agency

Medicare Care Compare
Listed as
Mary'S Help Home Health Services, IncCCN 059143
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Dec 7, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Medicare participation

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

Home health agency certification: CCN 059143

Legal name
MARY'S HELP HOME HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 7, 2009
Last certification
Oct 12, 2018
Ownership / control type
Proprietary
Organization structure
OtherProprietary
Incorporated
Apr 20, 2005 in CA
Enrollment address
3469 Tennessee St
Ste 101
Vallejo, CA 94591-4908
HHA Branch

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061027000518 CA Part A Provider - Home Health Agency 9537166889 Practice locations: Vallejo, CA

All disclosed owners & managing parties 3

Medicare enrollment files

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

NameRoleSinceShare
Bernabe F Urbano Individual Corporate DirectorMedical Director Apr 20, 2005
Joseph M Ibanez Individual 5% Or Greater Direct Ownership Interest Oct 16, 2006 50%
Corporate OfficerCeo Apr 20, 2005 50%
Corporate Director Oct 16, 2006 50%
Imelda L Ibanez Individual 5% Or Greater Direct Ownership Interest Oct 16, 2006 50%
Corporate OfficerCfo, Secretary Apr 20, 2005 50%
Corporate Director Oct 16, 2006 50%
W-2 Managing EmployeeAdministrator. DPCS Oct 16, 2006 100%

National Provider Directory

National Provider Directory

Locations

3469 Tennessee St
Ste 101
Vallejo, CA 94591
Phone (707) 645-7447

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

3469 Tennessee St
Suite 101
Vallejo, CA 94591-5688

Mailing address

3469 Tennessee St
Suite 101
Vallejo, CA 94591-5688
Phone (707) 645-7447

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1205929593MedicaidCA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 27, 2020.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1205929593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3469 TENNESSEE ST",
            "address_2": "SUITE 101",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945915688",
            "telephone_number": "707-645-7447",
            "fax_number": "707-645-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3469 TENNESSEE ST",
            "address_2": "SUITE 101",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945915688",
            "telephone_number": "707-645-7447",
            "fax_number": "707-645-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY'S HELP HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "DELFIN",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "650-581-1359"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205929593",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.