NPIMap

Organization Active NPI

Montrose Home Healthcare Inc

  • Home Health Agency
  • Glendale, CA
National Provider Identifier
1255407334
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MONTROSE HOME HEALTHCARE INC
Practice address
230 N Maryland Ave
Ste 203
Glendale, CA 91206-4261
Phone
(818) 545-0211
Fax
(818) 545-0221
NPI assigned
Nov 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Liberty Octoman Castillo
Title
Administrator
Phone
(818) 545-0211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X CA Primary

Addresses

Primary practice location

230 N Maryland Ave
Ste 203
Glendale, CA 91206-4261

Mailing address

230 N Maryland Ave
Ste 203
Glendale, CA 91206
Phone (818) 545-0211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030610000031 CA Part A Provider - Home Health Agency 3072423243 Practice locations: Glendale, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255407334. Details of each certification follow.

Home health agency certification: CCN 058303

Legal name
MONTROSE HOME HEALTHCARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 9, 2005
Last certification
Nov 3, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 25, 2003 in CA
Enrollment address
230 N Maryland Ave
Ste 104
Glendale, CA 91206-4283

Care Compare: Home health agency

Medicare Care Compare
Listed as
Montrose Home Healthcare, IncCCN 058303 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
May 9, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology

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
05D1018188Montrose Home Healthcare Inc230 N Maryland Ave Ste 104, Glendale, CA 91206Certificate of waiverOct 14, 2027

National Provider Directory

National Provider Directory

Locations

230 N Maryland Ave
Ste 104
Glendale, CA 91206
Phone (818) 545-0211

230 N Maryland Ave
Ste 203
Glendale, CA 91206
Phone (818) 545-0211

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
Leonardo K Castillo Individual 5% Or Greater Direct Ownership Interest Jun 24, 2005 50%
Corporate OfficerCfo/Board Members Jun 24, 2005 50%
Corporate DirectorCfo/Board Members Jun 24, 2005 50%
W-2 Managing EmployeeCfo/Board Members Jun 24, 2005 50%
Liberty O Castillo Individual 5% Or Greater Direct Ownership InterestManagerial/Administrator Jun 24, 2005 50%
Corporate OfficerCeo/Board Members Jun 24, 2005 50%
Corporate DirectorCeo/Board Members Jun 24, 2005 50%
W-2 Managing EmployeeCeo/Board Members Jun 24, 2005 50%
Neil Allen Ungson Individual W-2 Managing EmployeeDirector of Patient Care Service Apr 1, 2020

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 8

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": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255407334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N MARYLAND AVE",
            "address_2": "STE 203",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91206",
            "telephone_number": "818-545-0211",
            "fax_number": "818-545-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N MARYLAND AVE",
            "address_2": "STE 203",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064261",
            "telephone_number": "818-545-0211",
            "fax_number": "818-545-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTROSE HOME HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "LIBERTY",
        "authorized_official_middle_name": "OCTOMAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-545-0211"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.