Abundant Grace Home Health Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ABUNDANT GRACE HOME HEALTH SERVICES, INC.

Practice address

510 E Foothill Blvd Ste 102
San Dimas, CA 91773-1254

Phone

(844) 472-2301

Fax

(888) 254-3703

NPI assigned

Apr 23, 2019

Reactivated

Jun 19, 2023

Organization subpart

No

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

Authorized official

Name

Arlene G Abagon

Title

RN

Phone

(909) 868-8620

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 559470

Legal name

ABUNDANT GRACE HOME HEALTH SERVICES, INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 3, 2020

Last certification

Dec 3, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Apr 9, 2019 in CA

Enrollment address

510 E Foothill Blvd
Ste 102
San Dimas, CA 91773-1254
HHA Branch

Listed as

Abundant Grace Home Health Services, IncCCN 559470

Overall star rating

2 of 5

Ownership

Proprietary

Certified

Dec 3, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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 2

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

Practitioners 1

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

• Relyndo Manalo Salcedo, NURSE PRACTITIONER

  • Primary Care Nurse Practitioner
  • Fontana, CA
  • NPI 1649580630
  NPD

Affiliated clinicians 1

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

• Tam K Nguyen, M.D.

  • Internal Medicine Physician
  • Garden Grove, CA
  • NPI 1720153182

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1659935823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E FOOTHILL BLVD STE 102",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731254",
            "telephone_number": "844-472-2301",
            "fax_number": "888-254-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E FOOTHILL BLVD STE 102",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731254",
            "telephone_number": "844-472-2301",
            "fax_number": "888-254-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT GRACE HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-23",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "deactivation_date": "2023-05-22",
        "reactivation_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "ABAGON",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "909-868-8620"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Cyrus Abari, DDS
• Mohsen 'Robin' F Abari, DDS
• Nermen Nshat Helmy Abrahem
• Glenn Abrams
• Chantelle Abrolat, DDS
• Access Rehab Physical Therapy PC
• Charlene Adame
• Haley Marie Adams
• Eelliot Adomey, PSYCHOLOGY B.A.
• Adp of San Dimas, LLC

• Home Health Agency in San Dimas, CA
• Providers in San Dimas, 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 19, 2023; 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.