Organization Active NPI

Infinite Health Care Service LLC

Doing business as divine roses hospice

  • Community Based Hospice Care Agency
  • Carrollton, TX
National Provider Identifier
1255979407
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
INFINITE HEALTH CARE SERVICE LLC
Doing business as
divine roses hospice
Practice address
3000 Keller Springs Rd Ste 406
Carrollton, TX 75006-4891
Phone
(972) 695-6455
Fax
(972) 984-7967
NPI assigned
Dec 18, 2019
Last updated
Jul 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Authorized official

Name
Amina SultanNPI 1992343149
Title
Administrator
Phone
(972) 979-2033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

3000 Keller Springs Rd Ste 406
Carrollton, TX 75006-4891

Mailing address

3000 Keller Springs Rd Ste 406
Carrollton, TX 75006-4891

Other names 1

  • divine roses hospice Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bella.m@northtxbest.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201111001912 TX Part A Provider - Hospice 1951711472 Practice locations: Carrollton, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255979407. Details of each certification follow.

Hospice certification: CCN 971738

Legal name
INFINITE HEALTHCARE SERVICE LLC
Doing business as
DIVINÈ ROSES HOSPICE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 19, 2021
Last certification
Oct 19, 2021
Ownership / control type
Other
Organization structure
LLCProprietary
Incorporated
Dec 11, 2019 in TX
Enrollment address
3000 Keller Springs Rd
Ste 406
Carrollton, TX 75006-4891

Care Compare: Hospice

Medicare Care Compare
Listed as
Divin Roses Hospice CareCCN 971738 · All quality measures
Ownership
Other
Certified
Oct 19, 2021
Medicare certification status
ActiveFrom the Provider of Services file

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
45D2213883Divine Roses Hospice3000 Keller Springs Rd Suite 406, Carrollton, TX 75006Certificate of waiverFeb 16, 2027

National Provider Directory

National Provider Directory

Locations

3000 Keller Springs Rd
#406A
Carrollton, TX 75006

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Amina Sultan Individual 5% Or Greater Direct Ownership InterestOwner Dec 18, 2019 100%
Corporate OfficerGoverning Body Member Dec 18, 2019 100%
W-2 Managing EmployeeAdministrator & Director of Nurses Dec 18, 2019 100%
Operational/Managerial ControlAdministrator & Director of Nurses Jun 23, 2020 50%
Marballa Mojica Individual Contracted Managing EmployeeAlt.Admin Dec 19, 2019 100%
W-2 Managing EmployeeAlt.Administrator Dec 19, 2019 100%
Operational/Managerial ControlAlt Administrator Jun 23, 2020 50%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oxford Manor Health CenterOxford, PA, CCN 395367 Skilled nursing facility Adp of the SNF Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 1

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": "1576627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1255979407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 KELLER SPRINGS RD STE 406",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750064891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 KELLER SPRINGS RD STE 406",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750064891",
            "telephone_number": "972-695-6455",
            "fax_number": "972-984-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITE HEALTH CARE SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-18",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "SULTAN",
        "authorized_official_first_name": "AMINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "972-979-2033"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bella.m@northtxbest.com",
            "affiliation": "N",
            "address_1": "3000 Keller Springs Rd Ste 406",
            "city": "Carrollton",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750064891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "divine roses hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "divine roses hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, TX

Sources for this page

Verify at the official NPI Registry.