Addom, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ADDOM, INC.

Doing business as

Amazing Grace Home Health

Practice address

3260 Blume Dr
Suite 425
Richmond, CA 94806-5203

Phone

(510) 243-9987

Fax

(510) 243-9991

NPI assigned

Nov 10, 2014

Last updated

Nov 10, 2014By 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

Mr. Domique Paclibar, RN

Title

Vice-President

Phone

(510) 243-9987

Specialties & licenses 1

Addresses

Other names 1

• Amazing Grace Home Health Doing business as

Locations

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415577600000",
    "number": "1629474218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 BLUME DR",
            "address_2": "SUITE 425",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948065203",
            "telephone_number": "510-243-9987",
            "fax_number": "510-243-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 BLUME DR",
            "address_2": "SUITE 425",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948065203",
            "telephone_number": "510-243-9987",
            "fax_number": "510-243-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDOM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-10",
        "last_updated": "2014-11-10",
        "status": "A",
        "authorized_official_last_name": "PACLIBAR",
        "authorized_official_first_name": "DOMIQUE",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "510-243-9987",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amazing Grace Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Elizabeth Ackerman, NP
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• Angela Isabelle Aguilar
• Evelyn Marina Aguilar

• Home Health Agency in Richmond, CA
• Providers in Richmond, 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 Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.