Our Lady of Lourdes Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

550000749 Issued in CA

Legal business name

OUR LADY OF LOURDES HOME HEALTH, INC.

Practice address

8560 Vineyard Ave Ste 506
Rancho Cucamonga, CA 91730-4350

Phone

(909) 527-4543

Fax

(909) 527-4544

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Masoud Salehi

Title

President/Ceo

Phone

(909) 527-4542

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 059337

Legal name

OUR LADY OF LOURDES HOME HEALTH, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 22, 2011

Last certification

Jul 23, 2021

Ownership / control type

Proprietary

Most recent change of ownership

Jul 11, 2024

Organization structure

CorporationProprietary

Incorporated

Jan 26, 2006 in CA

Enrollment address

8560 Vineyard Ave
Ste 506
Rancho Cucamonga, CA 91730-4351

Listed as

Our Lady of Lourdes Home Health, IncCCN 059337 · All quality measures

Overall star rating

3 of 5

Ownership

Proprietary

Certified

Jun 22, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

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 3

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

Affiliated clinicians 1

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

• Tyson C. Landeza, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Torrance, CA
  • NPI 1235251117

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734998400000",
    "number": "1316958077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8560 VINEYARD AVE STE 506",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304350",
            "telephone_number": "909-527-4543",
            "fax_number": "909-527-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8560 VINEYARD AVE STE 506",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304350",
            "telephone_number": "909-527-4543",
            "fax_number": "909-527-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF LOURDES HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A",
        "authorized_official_last_name": "SALEHI",
        "authorized_official_first_name": "MASOUD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "909-527-4542"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "2827180",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "550000749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05-9337",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JCAHO",
            "identifier": "495500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Claire Oxtoby, PHD

• Home Health Agency in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, 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 Dec 24, 2024; 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.