NPIMap

Organization Active NPI

Modern Home Health Care, Inc.

  • Home Health Agency
  • Chula Vista, CA
National Provider Identifier
1235459843
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MODERN HOME HEALTH CARE, INC.
Practice address
3130 Bonita Rd
Suite 103
Chula Vista, CA 91910-3263
Phone
(619) 476-6619
Fax
(619) 585-1798
NPI assigned
Jun 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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

Authorized official

Name
Mrs. Tita T Manglicmot, RN
Title
Dopcs / Administrator
Phone
(619) 476-6619

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3130 Bonita Rd
Suite 103
Chula Vista, CA 91910-3263

Mailing address

3130 Bonita Rd
Suite 103
Chula Vista, CA 91910-3263
Phone (619) 476-6619

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110823000086 CA Part A Provider - Home Health Agency 5991975302 Practice locations: Chula Vista, CA

Home health agency certification: CCN 059391

Legal name
MODERN HOME HEALTH CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 14, 2012
Last certification
Jan 12, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 27, 2010 in CA
Enrollment address
3130 Bonita Rd
Ste 103
Chula Vista, CA 91910-3263

Care Compare: Home health agency

Medicare Care Compare
Listed as
Modern Home Health Care IncCCN 059391
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Jun 14, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2032198Modern Home Health Care, Inc.3130 Bonita Road, Suite 103, Chula Vista, CA 91910Certificate of waiverJun 11, 2028

National Provider Directory

National Provider Directory

Locations

3130 Bonita Rd
Ste 103
Chula Vista, CA 91910
Phone (619) 476-6619

1615 Sweetwater Rd
Unit G
National City, CA 91950
Phone (619) 477-1880

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
Michelle G Vigilia Individual 5% Or Greater Direct Ownership InterestSecretary Jul 16, 2020 33.33%
Corporate OfficerSecretary Mar 15, 2024 50%
Corporate DirectorBoard Member Mar 15, 2024 50%
Cherilyn Kimball Individual 5% Or Greater Direct Ownership InterestTreasurer Jul 16, 2020 33.34%
Corporate OfficerPresident, Treasurer Mar 15, 2024 50%
Corporate DirectorBoard Member Mar 15, 2024 50%
W-2 Managing EmployeeDopcs Mar 15, 2024 50%
Tita T Manglicmot Individual 5% Or Greater Direct Ownership InterestCeo Jul 16, 2020 33.33%
W-2 Managing EmployeeAdministrator Mar 15, 2024 50%

Practitioners & affiliated clinicians

Affiliated clinicians 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378339200000",
    "number": "1235459843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 BONITA RD",
            "address_2": "SUITE 103",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103263",
            "telephone_number": "619-476-6619",
            "fax_number": "619-585-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 BONITA RD",
            "address_2": "SUITE 103",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103263",
            "telephone_number": "619-476-6619",
            "fax_number": "619-585-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-04",
        "last_updated": "2013-09-05",
        "status": "A",
        "authorized_official_last_name": "MANGLICMOT",
        "authorized_official_first_name": "TITA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DOPCS / ADMINISTRATOR",
        "authorized_official_telephone_number": "619-476-6619",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.