Immaculate Home Health Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

IMMACULATE HOME HEALTH CARE LLC

Practice address

1600 S Dixie Hwy Ste 106
Boca Raton, FL 33432-7463

Phone

(954) 531-3585

Fax

(855) 299-5825

NPI assigned

Sep 23, 2020

Organization subpart

No

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

Authorized official

Name

Coretta WatersNPI 1447918842

Title

Owner

Phone

(954) 531-3585

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Home health agency certification: CCN 687294

Legal name

IMMACULATE HOME HEALTH CARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 23, 2023

Last certification

Feb 23, 2023

Organization structure

LLCProprietary

Incorporated

Sep 11, 2020 in FL

Enrollment address

1600 S Dixie Hwy
Ste 106
Boca Raton, FL 33432-7463
HHA Branch

Listed as

Immaculate Home Health Care LLCCCN 687294

Ownership

-

Certified

Feb 23, 2023

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.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Coretta B Waters, RN

  • Registered Nurse
  • Boca Raton, FL
  • NPI 1447918842
  NPD Authorized official

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703548800000",
    "number": "1346856416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S DIXIE HWY STE 106",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334327463",
            "telephone_number": "954-531-3585",
            "fax_number": "855-299-5825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S DIXIE HWY STE 106",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334327463",
            "telephone_number": "954-531-3585",
            "fax_number": "855-299-5825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6101 W Atlantic Blvd Ste 212",
            "address_purpose": "LOCATION",
            "city": "Margate",
            "state": "FL",
            "postal_code": "330635157",
            "country_code": "US",
            "telephone_number": "954-531-3585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IMMACULATE HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-23",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "CORETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-531-3585"
    },
    "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 Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.