Saddleback Home Health Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SADDLEBACK HOME HEALTH SERVICES, INC.

Practice address

502 W Route 66 Ste 26
Glendora, CA 91740-4382

Phone

(626) 628-6404

Fax

(626) 628-3424

NPI assigned

Jan 24, 2018

Organization subpart

No

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

Authorized official

Name

Mia Josefa Juaneza

Title

President

Phone

(626) 628-6404

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 559701

Legal name

SADDLEBACK HOME HEALTH SERVICES, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 22, 2021

Last certification

Dec 22, 2021

Organization structure

CorporationProprietary

Incorporated

Oct 23, 2017 in CA

Enrollment address

502 W Route 66
Ste 26
Glendora, CA 91740-4382

Listed as

Saddleback Home Health Services, IncCCN 559701

Ownership

-

Certified

Dec 22, 2021

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

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": "1516752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516752000000",
    "number": "1306344353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 GENOA ST UNIT C",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910164505",
            "telephone_number": "424-202-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W ROUTE 66 STE 26",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404382",
            "telephone_number": "626-628-6404",
            "fax_number": "626-628-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SADDLEBACK HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-24",
        "last_updated": "2018-01-24",
        "status": "A",
        "authorized_official_last_name": "JUANEZA",
        "authorized_official_first_name": "MIA JOSEFA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-628-6404"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Glendora, CA
• Providers in Glendora, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.