NPIMap

Organization Active NPI

Mallari Healthcare, Inc.

Doing business as LifeGuard Home Health

  • Home Health Agency
  • Pleasanton, CA
National Provider Identifier
1225280951
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MALLARI HEALTHCARE, INC.
Doing business as
LifeGuard Home Health
Practice address
6700 Koll Center Pkwy Ste 116
Pleasanton, CA 94566-7034
Phone
(925) 271-0221
Fax
(925) 800-3093
NPI assigned
Oct 13, 2008
Last updated
Sep 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Mr. Roel J. M. Mallari, BS CIVIL ENGINEERING
Title
Ceo
Phone
(925) 271-0221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

6700 Koll Center Pkwy Ste 116
Pleasanton, CA 94566-7034

Mailing address

6700 Koll Center Pkwy Ste 116
Pleasanton, CA 94566-7034
Phone (925) 271-0221

Other names 1

  • LifeGuard Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081113000111 CA Part A Provider - Home Health Agency 9537228010 Practice locations: Pleasanton, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225280951. Details of each certification follow.

Home health agency certification: CCN 059055

Legal name
MALLARI HEALTHCARE INC
Doing business as
LIFEGUARD HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 3, 2009
Last certification
Aug 10, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Sep 23, 2008 in CA
Enrollment address
6700 Koll Center Pkwy
Ste 116
Pleasanton, CA 94566-7032

Care Compare: Home health agency

Medicare Care Compare
Listed as
Lifeguard Home HealthCCN 059055 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Sep 3, 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

371 Gresel St
Hayward, CA 94544
Phone (510) 401-0007

5976 W Las Positas Blvd
Ste 106
Pleasanton, CA 94588
Phone (925) 271-0221

6700 Koll Center Pkwy
Ste 116
Pleasanton, CA 94566
Phone (925) 271-0221

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Roel Mallari Individual 5% Or Greater Direct Ownership Interest Oct 20, 2008 29%
Corporate Director Oct 20, 2008
Jeffrey Mallari Individual 5% Or Greater Direct Ownership Interest Oct 20, 2008 15%
Corporate Director Oct 20, 2008
Consuelo Lemye Individual 5% Or Greater Direct Ownership Interest Oct 20, 2008 5%
Corporate Director Oct 20, 2008
W-2 Managing Employee Oct 20, 2008
Editha M Mallari Individual 5% Or Greater Direct Ownership Interest Oct 20, 2008 51%
Corporate Director Oct 20, 2008

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1225280951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 KOLL CENTER PKWY STE 116",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667034",
            "telephone_number": "925-271-0221",
            "fax_number": "925-800-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 KOLL CENTER PKWY STE 116",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667034",
            "telephone_number": "925-271-0221",
            "fax_number": "925-800-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLARI HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-13",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "MALLARI",
        "authorized_official_first_name": "ROEL",
        "authorized_official_middle_name": "J. M.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-271-0221",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS CIVIL ENGINEERING"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeGuard Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LifeGuard Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.