NPIMap

Organization Active NPI

Family Home Health Agency LLC

  • Home Health Agency
  • Arcadia, CA
National Provider Identifier
1285728717
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
251E00000X Issued in CA
Legal business name
FAMILY HOME HEALTH AGENCY LLC
Practice address
411 E Huntington Dr
Suite 210
Arcadia, CA 91006-3731
Phone
(626) 446-8500
Fax
(626) 446-8501
NPI assigned
Oct 2, 2006
Last updated
Feb 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Authorized official

Name
Edwin L Lim
Title
Vice President
Phone
(626) 446-8500

Specialties & licenses 1

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

Addresses

Primary practice location

411 E Huntington Dr
Suite 210
Arcadia, CA 91006-3731

Mailing address

411 E Huntington Dr
Suite 210
Arcadia, CA 91006-3731
Phone (626) 446-8500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040224001300 CA Part A Provider - Home Health Agency 5890681050 Practice locations: Glendora, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285728717. Details of each certification follow.

Home health agency certification: CCN 058451

Legal name
FAMILY HOME HEALTH AGENCY LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 1, 2008
Last certification
Oct 27, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 19, 2003 in CA
Enrollment address
1200 E Route 66
Ste 206a
Glendora, CA 91740-6390

Care Compare: Home health agency

Medicare Care Compare
Listed as
Family Home Health Agency, LLCCCN 058451 · All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Apr 1, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
05D1021932Family Home Health Agency LLC1200 E Route 66 Ste 206a, Glendora, CA 91740Certificate of waiverFeb 2, 2028

National Provider Directory

National Provider Directory

Locations

411 E Huntington Dr
Ste 210
Arcadia, CA 91006
Phone (626) 446-8500

1200 E Route 66
Ste 206A
Glendora, CA 91740
Phone (626) 446-8500

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
Edwin L Lim Individual 5% Or Greater Direct Ownership InterestCfo Jul 11, 2006 50%
Corporate OfficerCfo Jul 11, 2006 50%
Corporate DirectorCfo Jul 11, 2006 50%
W-2 Managing EmployeeCfo Jul 11, 2006 50%
Carina Rosette D Torres Individual 5% Or Greater Direct Ownership InterestCeo Jul 11, 2006 50%
Corporate OfficerCe0 Jul 11, 2006 50%
Corporate DirectorCeo Jul 11, 2006 50%
W-2 Managing EmployeeAdministrator Jul 11, 2006 50%

Practitioners & affiliated clinicians

Affiliated clinicians 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1285728717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E HUNTINGTON DR",
            "address_2": "SUITE 210",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063731",
            "telephone_number": "626-446-8500",
            "fax_number": "626-446-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E HUNTINGTON DR",
            "address_2": "SUITE 210",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063731",
            "telephone_number": "626-446-8500",
            "fax_number": "626-446-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HOME HEALTH AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2009-02-09",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "626-446-8500"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "251E00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.