NPIMap

Organization Active NPI

Healthy Living at Home - Vancouver, LLC

  • Home Health Agency
  • Vancouver, WA
National Provider Identifier
1255812020
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
HEALTHY LIVING AT HOME - VANCOUVER, LLC
Practice address
1499 SE Tech Center PL Ste 140
Vancouver, WA 98683-9575
Phone
(360) 859-4886
Fax
(360) 859-4891
NPI assigned
Aug 28, 2018
Last updated
Jul 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Authorized official

Name
Stephen Murphy
Title
SVP, Finance
Phone
(888) 871-0766

Specialties & licenses 1

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

Addresses

Primary practice location

1499 SE Tech Center PL Ste 140
Vancouver, WA 98683-9575

Mailing address

2365 Northside Dr Ste 200
San Diego, CA 92108-2720
Phone (888) 871-0766

Other names 1

  • Healthy Living at Home - Vancouver, LLC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181106002295 WA Part A Provider - Home Health Agency 5496009698 Practice locations: Vancouver, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255812020. Details of each certification follow.

Home health agency certification: CCN 507127

Legal name
HEALTHY LIVING AT HOME - VANCOUVER, LLC
Doing business as
MISSION HOME HEALTH OF VANCOUVER
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 8, 2019
Last certification
Mar 8, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Nov 4, 2016 in WA
Enrollment address
1499 SE Tech Center PL
Ste 140
Vancouver, WA 98683-9575

Care Compare: Home health agency

Medicare Care Compare
Listed as
Healthy Living at Home - Vancouver LLCCCN 507127 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Mar 8, 2019
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

1499 SE Tech Center Pl
Ste 140
Vancouver, WA 98683
Phone (360) 859-4886

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Gregory J. Vislocky Individual 5% Or Greater Indirect Ownership Interest Oct 11, 2018 7.8%
Mission Healthcare Intermediate Holdings LLC Organization, San Diego, CA LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2021 74%
TVG Bolt Buyer, LLC Organization, Chicago, IL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2021 35.36%
HLH Vancouver Holdings, LLC Organization, San Diego, CA LLC 5% Or Greater Direct Ownership Interest Oct 11, 2017 100%
Operational/Managerial Control Oct 11, 2017
Capricorn Healthcare & Special Opportunities II, LP Organization, Chicago, IL For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2021 6.84%
MH Holdings Management Holdco LLC Organization, Chicago, IL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2021 15.88%
Vistria Fund III (Ft) LP Organization, Chicago, IL Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2021 11.35%
HLH Vancouver-Wenatchee Holdings, LLC Organization, San Diego, CA Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 11, 2018 100%
TVG MH Holdings III (Ft) LP Organization, Chicago, IL Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2021 11.64%
TVG MH Intermediate Holdings LLC Organization, Chicago, IL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2021 74%
HLH TVG Holdings, LLC Organization, San Diego, CA LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2021 74%
TVG MH III (Ft) Blocker LLC Organization, Chicago, IL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2021 11.64%
Steve Murphy Individual Corporate OfficerSVP, Finance Jun 5, 2023
Operational/Managerial ControlSVP, Finance Jun 5, 2023
Brian R Delamarter Individual 5% Or Greater Indirect Ownership Interest Oct 11, 2018 10.83%
D. D. & F. Organization, San Diego, CA For-profit 5% Or Greater Indirect Ownership Interest Oct 11, 2018 26%
TVG MH Holdings LLC Organization, San Diego, CA LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2021 74%
Vistria Fund III LP Organization, Chicago, IL Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2021 23.71%
Harold G Delamarter Individual 5% Or Greater Indirect Ownership Interest Oct 11, 2018 7.37%
HLH Opco LLC Organization, San Diego, CA LLC, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2021 74%

Facilities with the same owner 96

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 96

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1255812020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 NORTHSIDE DR STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082720",
            "telephone_number": "888-871-0766",
            "fax_number": "866-551-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 SE TECH CENTER PL STE 140",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839575",
            "telephone_number": "360-859-4886",
            "fax_number": "360-859-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIVING AT HOME - VANCOUVER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-28",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "SVP, FINANCE",
        "authorized_official_telephone_number": "888-871-0766"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Living at Home - Vancouver, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Healthy Living at Home - Vancouver, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.