St. Francis Home Health Agency, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ST. FRANCIS HOME HEALTH AGENCY, INC.

Doing business as

St. Francis Home Health Agency

Practice address

10970 Arrow Rte Ste 205
Rancho Cucamonga, CA 91730-4839

Phone

(909) 989-7700

Fax

(909) 457-6353

NPI assigned

Mar 8, 2018

Last updated

Feb 7, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Martin Aiyetiwa

Title

President/Ceo

Phone

(909) 989-7700

Specialties & licenses 3

Addresses

Other names 1

• St. Francis Home Health Agency Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356844096. Details of each certification follow.

• CCN 559704 Home health agency · Active · Details

Home health agency certification: CCN 559704

Legal name

ST FRANCIS HOME HEALTH AGENCY, INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 28, 2021

Last certification

Dec 8, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jan 29, 2019 in CA

Enrollment address

10970 Arrow Rte
Ste 205
Rancho Cucamonga, CA 91730-4839
HHA Branch

Listed as

St Francis Home Health Agency, IncCCN 559704 · All quality measures

Ownership

Proprietary

Certified

Dec 28, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

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.

Affiliated clinicians 1

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

• Abdel Karim Ahmad

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1124644752

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581033600000",
    "number": "1356844096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10970 ARROW RTE STE 206",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304839",
            "telephone_number": "909-989-5383",
            "fax_number": "909-457-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10970 ARROW RTE STE 205",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304839",
            "telephone_number": "909-989-7700",
            "fax_number": "909-457-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. FRANCIS HOME HEALTH AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-08",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "AIYETIWA",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "909-989-7700"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Francis Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Feb 7, 2020; 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.