Sweetgrace Home Health Services, LLC.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

565467 Issued in CA

Legal business name

SWEETGRACE HOME HEALTH SERVICES, LLC.

Practice address

6101 Cherry Ave
Suite 206
Fontana, CA 92336-5362

Phone

(909) 463-7400

Fax

(909) 463-7442

NPI assigned

Jun 21, 2007

Organization subpart

No

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

Authorized official

Name

Lourdes R. Garcia, REGISTERED NURSE

Title

President

Phone

(909) 463-7400

Specialties & licenses 1

Addresses

Other names 1

• DBA Grace Home Health Nursing Services Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 059216

Legal name

SWEETGRACE HOME HEALTH SERVICES LLC

Doing business as

GRACE HOME HEALTH NURSING SERVICES

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jan 4, 2010

Last certification

Aug 19, 2016

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Jun 12, 2007 in CA

Enrollment address

6101 Cherry Ave
Ste 108
Fontana, CA 92336-5362
HHA Branch

Listed as

Sweetgrace Home Health Services, LLCCCN 059216

Overall star rating

4 of 5

Ownership

Proprietary

Certified

Jan 4, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Tax ID family

Dba Grace Home Health Nursing Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sweetgrace Home Health Services, LLC

  • Home Health Agency
  • Fontana, CA
  • NPI 1467865352
  NPD tax ID

Locations

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.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Mohamed Sellami, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Bay Shore, NY
  • NPI 1629021019

  Corporate Director

  CMS ownership

Affiliated clinicians 2

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

• Ghassan E. Boghosian, DO

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Rancho Mirage, CA
  • NPI 1255479044

  Home health agency

  Care Compare affiliation
• Erik Allen Schnaser, M.D.

  • Orthopaedic Surgery Physician
  • Rancho Mirage, CA
  • NPI 1538340195

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346976000000",
    "number": "1245435957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 CHERRY AVE",
            "address_2": "SUITE 206",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365362",
            "telephone_number": "909-463-7400",
            "fax_number": "909-463-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 CHERRY AVE",
            "address_2": "SUITE 206",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365362",
            "telephone_number": "909-463-7400",
            "fax_number": "909-463-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEETGRACE HOME HEALTH SERVICES, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2012-09-07",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "LOURDES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-463-7400",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "565467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Grace Home Health Nursing Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy M Svitek, M.D.
• Dexa Jo Swanson, RPH
• Jon R Swanson, LCSW
• Scott Swartz, NP
• Sweetgrace Home Health Services, LLC
• Theodore Earl Swigart IV, PH.D.
• Azeem Abdul Syed, PHARMD
• Azra Syed, MD
• Ibolya Szuromi, M.A.
• Hanieh Sadat Tabatabaei Yeganeh

• Home Health Agency in Fontana, CA
• Providers in Fontana, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.