NPIMap

Organization Active NPI

Jubilee Home Health Care, Inc.

  • Home Health Agency
  • Simi Valley, CA
National Provider Identifier
1235319062
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
JUBILEE HOME HEALTH CARE, INC.
Practice address
4195 Valley Fair St
Suite 200
Simi Valley, CA 93063-2953
Phone
(805) 578-9806
Fax
(805) 578-4609
NPI assigned
Nov 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Authorized official

Name
Mrs. Nimfa C Simbulan
Title
Chief Operating Officer
Phone
(805) 578-9806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4195 Valley Fair St
Suite 200
Simi Valley, CA 93063-2953

Mailing address

4195 Valley Fair St
Suite 200
Simi Valley, CA 93063-2953
Phone (805) 578-9806

Other identifiers 1

IdentifierTypeStateIssuer
3025180OtherCACA CORP. NO.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080116000455 CA Part A Provider - Home Health Agency 4385732551 Practice locations: Simi Valley, CA

Home health agency certification: CCN 059133

Legal name
JUBILEE HOME HEALTH CARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 30, 2010
Last certification
Nov 30, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Aug 29, 2007 in CA
Enrollment address
4195 Valley Fair St
Ste 200
Simi Valley, CA 93063-2951
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Jubilee Home Health Care IncCCN 059133
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Jan 30, 2010
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

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
Eudocia P. Vincecruz Individual 5% Or Greater Direct Ownership Interest Jul 15, 2014 33%
Corporate OfficerCfo/Administrator/Secretary Jul 15, 2014 33%
W-2 Managing EmployeeCfo/Administrator/Secretary Nov 8, 2007 33%
Marilou C Lectura Individual 5% Or Greater Direct Ownership Interest Jul 15, 2014 33%
Corporate OfficerRN/Ceo/President/DPCS Jul 15, 2014 33%
W-2 Managing EmployeeRN/Ceo/President/DPCS Jul 15, 2014 33%
Editha Clarin Individual 5% Or Greater Direct Ownership Interest Nov 1, 2007 33%
Corporate DirectorDirector Nov 8, 2007 33%

Practitioners & affiliated clinicians

Affiliated clinicians 3

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

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280275200000",
    "number": "1235319062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4195 VALLEY FAIR ST",
            "address_2": "SUITE 200",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930632953",
            "telephone_number": "805-578-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4195 VALLEY FAIR ST",
            "address_2": "SUITE 200",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930632953",
            "telephone_number": "805-578-9806",
            "fax_number": "805-578-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUBILEE HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2010-07-28",
        "status": "A",
        "authorized_official_last_name": "SIMBULAN",
        "authorized_official_first_name": "NIMFA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "805-578-9806",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA CORP. NO.",
            "identifier": "3025180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.