Concordia Health Care Provider Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CONCORDIA HEALTH CARE PROVIDER INC.

Practice address

2225 W. Commonwealth Ave.,
Suite 305
Alhambra, CA 91803-1335

Phone

(626) 281-7400

Fax

(626) 281-7401

NPI assigned

Oct 3, 2008

Organization subpart

No

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

Authorized official

Name

Rosita A Balao, RN

Title

Administrator

Phone

(626) 281-7400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 059327

Legal name

CONCORDIA HEALTH CARE PROVIDER INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 19, 2011

Last certification

Nov 5, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Sep 12, 2008 in CA

Enrollment address

2120 Foothill Blvd
Ste 102
La Verne, CA 91750-2948
HHA Branch

Listed as

Concordia Health Care Provider, IncCCN 059327

Overall star rating

4.5 of 5

Ownership

Proprietary

Certified

Jul 19, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

Locations

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.

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1275784696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 W COMMONWEALTH AVE STE 305",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918031335",
            "telephone_number": "626-281-7400",
            "fax_number": "626-281-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 W. COMMONWEALTH AVE.,",
            "address_2": "SUITE 305",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918031335",
            "telephone_number": "626-281-7400",
            "fax_number": "626-281-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORDIA HEALTH CARE PROVIDER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "BALAO",
        "authorized_official_first_name": "ROSITA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-281-7400",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.