Albacare Home Health Services LLC

Organization Active NPI Home Health Agency · Holden, MA

NPI 1558001073 · NPPES record last updated Mar 31, 2022

Key facts

NPI
1558001073
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
Legal business name
ALBACARE HOME HEALTH SERVICES LLC
Practice address
71 Cranbrook Dr
Holden, MA 01520-1474
Phone
(774) 641-8538
NPI assigned
Mar 31, 2022
Organization subpart
No

Authorized official

Name
Julian Qirko
Title
Owner/President
Phone
(774) 641-8538

Medicare Care Compare: Home health agency

Listed as
Albacare Home Health Services LLC CCN 227766
Ownership
-
Certified
Aug 1, 2023
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2277903Albacare Home Health Services LLC
71 Cranbrook Dr, Holden, MA 01520
Certificate of waiverMar 6, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA

Home health agency certification: CCN 227766

Legal name
ALBACARE HOME HEALTH SERVICES LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 1, 2023
Last certification
Jul 7, 2023
Organization structure
LLC · Proprietary
Incorporated
Mar 30, 2022 in MA
Enrollment address
71 Cranbrook Dr
Holden, MA 01520-1474

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.

NameRoleSinceShare
Julian Qirko
Individual
5% Or Greater Direct Ownership Interest Mar 30, 2022 100%
Corporate Officer
Owner/President/Admin
Mar 30, 2022 100%
Corporate Director
Owner/President/Admin
Mar 30, 2022 100%
W-2 Managing Employee
Owner/President/Admin
Mar 30, 2022 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220624001114 MA Part a Provider - Home Health Agency 1850770629 Practice locations: Holden, MA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Yes

Addresses

Primary practice location

71 Cranbrook Dr
Holden, MA 01520-1474

Mailing address

71 Cranbrook Dr
Holden, MA 01520-1474
Phone (774) 641-8538

Other providers in Holden, MA

All providers in Holden, MA · Home Health Agency in Massachusetts

Sources for this page

Verify at the official NPI Registry.