Harbor Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

HARBOR HOME HEALTH, INC.

Practice address

640 S Sunset Ave Ste 205
West Covina, CA 91790-2808

Phone

(626) 679-3645

NPI assigned

Feb 17, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Marie Cecile Evangelista

Title

Board Secretary

Phone

(626) 679-3645

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757010

Legal name

HARBOR HOME HEALTH, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 21, 2022

Last certification

Oct 20, 2022

Organization structure

CorporationProprietary

Incorporated

Jan 27, 2021 in CA

Enrollment address

640 S Sunset Ave
Ste 205
West Covina, CA 91790-2808

Listed as

Harbor Home Health, Inc.CCN 757010

Ownership

-

Certified

Oct 21, 2022

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 8

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

Affiliated clinicians 2

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

• George Mousa, MD

  • Internal Medicine Physician
  • San Bernardino, CA
  • NPI 1144711821

  Home health agency

  Care Compare affiliation
• Kirit C. Shah, M.D.

  • Internal Medicine Physician
  • Arcadia, CA
  • NPI 1699783035

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1467045781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 MEADOW LN",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102600",
            "telephone_number": "626-608-1800",
            "fax_number": "626-608-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S SUNSET AVE STE 205",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902808",
            "telephone_number": "626-679-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-17",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "EVANGELISTA",
        "authorized_official_first_name": "MARIE CECILE",
        "authorized_official_title_or_position": "BOARD SECRETARY",
        "authorized_official_telephone_number": "626-679-3645",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina V Hanna, M.D.
• Ragaa Hanna
• Kambiz Hannani, MD
• Azhar Ul Haq, M.D.
• Cindy Harapan
• Theodore Hardwick
• Harmon Physical Therapy, Inc.
• Buford K Harmon, P.T.
• Marissa Raquel Haro
• Harold Gomez Millennium, Inc

• Home Health Agency in West Covina, CA
• Providers in West Covina, 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 28, 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.