NPIMap

Organization Active NPI

Legacy Homecare, Inc.

  • Home Health Agency
  • Whittier, CA
National Provider Identifier
1528045671
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LEGACY HOMECARE, INC.
Practice address
11036 Washington Blvd Ste a
Whittier, CA 90606-3006
Phone
(562) 568-0162
Fax
(562) 568-0161
NPI assigned
Dec 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Authorized official

Name
Ms. Lea Dychingco
Title
Owner Ceo
Phone
(562) 568-0162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X CA Primary

Addresses

Primary practice location

11036 Washington Blvd Ste a
Whittier, CA 90606-3006

Mailing address

11036 Washington Blvd Ste a
Whittier, CA 90606-3006
Phone (562) 568-0162

Other identifiers 1

IdentifierTypeStateIssuer
HHA08137FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070410000472 CA Part A Provider - Home Health Agency 4587618517 Practice locations: Whittier, CA

Home health agency certification: CCN 058137

Legal name
LEGACY HOMECARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 27, 2002
Last certification
Sep 13, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Dec 3, 2002 in CA
Enrollment address
11036 Washington Blvd
# A
Whittier, CA 90606-3006

Care Compare: Home health agency

Medicare Care Compare
Listed as
Legacy Homecare, IncCCN 058137
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Sep 27, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0998819Legacy Homecare Inc11036 E Washington Blvd Ste a, Whittier, CA 90606Certificate of waiverMay 17, 2027

National Provider Directory

National Provider Directory

Locations

11036 Washington Blvd
Ste A
Whittier, CA 90606
Phone (562) 568-0162

Ownership & related parties

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.

NameRoleSinceShare
Lea O Dychingco Individual 5% Or Greater Direct Ownership InterestCeo, Board Member, Cfo Jan 30, 2007 100%
Corporate OfficerCeo, Board Member, Cfo Feb 3, 2007 100%
Corporate DirectorBoard Director Feb 3, 2007 100%
W-2 Managing EmployeeAdministrator Feb 3, 2007 100%
Jesus Ong Individual Corporate DirectorDirector of Nursing Feb 1, 2017
Catherine Azubuike Individual W-2 Managing EmployeeDirector of Nursing Feb 3, 2007 100%
Marian Jalil Individual Contracted Managing EmployeeMedical Director Feb 3, 2007 100%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 5

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

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1528045671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11036 WASHINGTON BLVD STE A",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906063006",
            "telephone_number": "562-568-0162",
            "fax_number": "562-568-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11036 WASHINGTON BLVD STE A",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906063006",
            "telephone_number": "562-568-0162",
            "fax_number": "562-568-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HOMECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "DYCHINGCO",
        "authorized_official_first_name": "LEA",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "562-568-0162",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA08137F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.