Home Rehabilitation Healthcare Agency Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

980001566 Issued in CA

Legal business name

HOME REHABILITATION HEALTHCARE AGENCY INC.

Practice address

644 E Regent St
Suite 101
Inglewood, CA 90301-4502

Phone

(310) 677-4400

Fax

(310) 677-4407

NPI assigned

Nov 16, 2005

Last updated

Jun 2, 2016By 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

Ms. Joy Tyson, RN BSN

Title

Director of Nursing Administrator

Phone

(310) 677-4400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447232335. Details of each certification follow.

• CCN 058265 Home health agency · Active · Details

Home health agency certification: CCN 058265

Legal name

HOME REHABILITATION HEALTHCARE AGENCY, INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 6, 2004

Last certification

Jan 16, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Feb 1, 2003 in CA

Enrollment address

2930 W Imperial Hwy
Ste 317
Inglewood, CA 90303-3141

Listed as

Home Rehabilitation Health Care AgencyCCN 058265 · All quality measures

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

May 6, 2004

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 4

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Matthew Reddick Perry Jr., RPT

  • Physical Therapist
  • Inglewood, CA
  • NPI 1356363360

  5% Or Greater Direct Ownership Interest, Corporate Director, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 2

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

• William T Long, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Los Angeles, CA
  • NPI 1023067055

  Home health agency

  Care Compare affiliation
• Amanuel Sima, M.D.

  • Internal Medicine Physician
  • Beverly Hills, CA
  • NPI 1366493744

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464825600000",
    "number": "1447232335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 E REGENT ST",
            "address_2": "SUITE 101",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011433",
            "telephone_number": "310-677-4400",
            "fax_number": "310-677-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 E REGENT ST",
            "address_2": "SUITE 101",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014502",
            "telephone_number": "310-677-4400",
            "fax_number": "310-677-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME REHABILITATION HEALTHCARE AGENCY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2016-06-02",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING ADMINISTRATOR",
        "authorized_official_telephone_number": "310-677-4400",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN BSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5371136",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charmaine M Holland
• Beatrice Pokuaah Holloway
• Hollywood Hospice Care Inc.
• Erica Holmes, PSYD
• Staci Holmes, PHLEBOTOMIST
• Seung Wan Hong, L.AC
• William H. Hong, MD
• Hope House LLC
• Hope Medical Supply,LLC.
• Michaela Hoskins

• Home Health Agency in Inglewood, CA
• Providers in Inglewood, 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 Jun 2, 2016; 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.