Organization Active NPI

Select Care Home Health, Inc.

  • Home Health Agency
  • Cypress, TX
National Provider Identifier
1598761132
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
007966 Issued in TX
Legal business name
SELECT CARE HOME HEALTH, INC.
Practice address
11803 Grant Rd
Ste 203
Cypress, TX 77429-4022
Phone
(281) 370-3500
Fax
(281) 370-3567
NPI assigned
Jun 27, 2005
Last updated
Jan 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Authorized official

Name
Roberto Goan
Title
Administrator
Phone
(281) 370-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 007966 TX Primary

Addresses

Primary practice location

11803 Grant Rd
Ste 203
Cypress, TX 77429-4022

Mailing address

11803 Grant Rd
Ste 203
Cypress, TX 77429-4022
Phone (281) 370-3500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071211000170 TX Part A Provider - Home Health Agency 8921197146 Practice locations: Cypress, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598761132. Details of each certification follow.

Home health agency certification: CCN 679170

Legal name
SELECT CARE HOME HEALTH, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 17, 2002
Last certification
Mar 29, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 18, 2002 in TX
Enrollment address
11803 Grant Road
Suite 203
Cypress, TX 77429-4022

Care Compare: Home health agency

Medicare Care Compare
Listed as
Select Care Home Health, Inc.CCN 679170 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Oct 17, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical 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
45D0998723Select Care Home Health, Inc11803 Grant Road, Suite 203, Cypress, TX 77429Certificate of waiverApr 22, 2028

National Provider Directory

National Provider Directory

Locations

11803 Grant Rd
Ste 203
Cypress, TX 77429
Phone (281) 370-3500

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Soledad Banea Individual 5% Or Greater Direct Ownership InterestDirector Jan 1, 2025 33%
Corporate DirectorDirector Jan 1, 2025 33%
W-2 Managing EmployeeDirector / Alt Administrator Jan 1, 2025 33%
Operational/Managerial ControlDirector / Alt Administrator Jan 1, 2025 33%
Robert S Goan Individual Corporate OfficerCfo May 1, 2018
W-2 Managing EmployeeAd; May 1, 2018
Operational/Managerial ControlAdministrator / Cfo May 18, 2018
Manuel Sagullo Individual 5% Or Greater Direct Ownership InterestCeo / Director Jan 1, 2025 67%
Corporate OfficerCeo / Director Jan 1, 2025 67%
Corporate DirectorCeo / Director Jan 1, 2025 67%
Operational/Managerial ControlCeo / Director Jan 1, 2025 67%

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1598761132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11803 GRANT RD",
            "address_2": "STE 203",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294022",
            "telephone_number": "281-370-3500",
            "fax_number": "281-370-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11803 GRANT RD",
            "address_2": "STE 203",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294022",
            "telephone_number": "281-370-3500",
            "fax_number": "281-370-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT CARE HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "GOAN",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "281-370-3500"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "007966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.