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
Last updated
May 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

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

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205929593. Details of each certification follow.

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Mary's Help Home Health Services, IncCCN 059143 · All quality measures
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

National Provider Directory

National Provider Directory

Locations

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

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
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%

Practitioners & affiliated clinicians

Affiliated clinicians 36

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

View all 36

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.