Organization Active NPI

Affordable Priority Home Health Services LLC

  • Home Health Agency
  • Roslindale, MA
National Provider Identifier
1215312590
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
AFFORDABLE PRIORITY HOME HEALTH SERVICES LLC
Practice address
43 Cummins Hwy
Roslindale, MA 02131-2523
Phone
(617) 230-6824
Fax
(617) 600-3555
NPI assigned
Jul 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Authorized official

Name
Mr. Emmanuel M Fombe
Title
Director
Phone
(617) 230-6824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

43 Cummins Hwy
Roslindale, MA 02131-2523

Mailing address

43 Cummins Hwy
Suite 3
Roslindale, MA 02131-2523
Phone (617) 230-6824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160719000313 MA Part A Provider - Home Health Agency 5496048126 Practice locations: Roslindale, MA

Home health agency certification: CCN 227733

Legal name
AFFORDABLE PRIORITY HOME HEALTH SERVICES LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 27, 2019
Last certification
Nov 27, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Aug 19, 2015 in MA
Enrollment address
43 Cummins Hwy
Ste 3
Roslindale, MA 02131-2523

Care Compare: Home health agency

Medicare Care Compare
Listed as
Affordable Priority Home Health Services LLCCCN 227733
Ownership
Proprietary
Certified
Nov 27, 2019
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy

National Provider Directory

National Provider Directory

Locations

43 Cummins Hwy
Ste 3
Roslindale, MA 02131
Phone (617) 230-6824

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
Gaston Poufong Individual 5% Or Greater Direct Ownership InterestAdministrator Sep 3, 2015 25%
Corporate OfficerAdministrator/Board Member Sep 3, 2015
Corporate DirectorAdministrator/Board Member Sep 3, 2016
W-2 Managing EmployeeAd; Sep 3, 2016
Operational/Managerial ControlAdministrator/Board Member Sep 3, 2016
Emmanuel M Fombe Individual 5% Or Greater Direct Ownership Interest Sep 3, 2015 75%
Corporate OfficerGoverning Board Member Sep 3, 2015
Corporate Director/Ceo/Board Member Sep 3, 2015
Operational/Managerial ControlCeo/Board Member Sep 3, 2016

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1215312590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 CUMMINS HWY",
            "address_2": "SUITE 3",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021312523",
            "telephone_number": "617-230-6824",
            "fax_number": "617-600-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 CUMMINS HWY",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021312523",
            "telephone_number": "617-230-6824",
            "fax_number": "617-600-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE PRIORITY HOME HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "FOMBE",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "617-230-6824",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslindale, MA

Sources for this page

Verify at the official NPI Registry.