A Prime Home Health Services, Inc
Organization Active NPI Home Health Agency · Camarillo, CA
NPI 1669922183 · NPPES record last updated Oct 7, 2016
Key facts
- NPI
- 1669922183
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- A PRIME HOME HEALTH SERVICES, INC
- Practice address
- 266 Mobil Ave Ste 215
Camarillo, CA 93010-6336 - Phone
- (877) 332-6755
- Fax
- (805) 322-7055
- NPI assigned
- Oct 7, 2016
- Organization subpart
- No
Authorized official
- Name
- Mr. Carl Cadducius Villaluz
- Title
- Ceo
- Phone
- (877) 332-6755
Affiliated clinicians 10
-
Raphael A Argueta, M.D.
-
Desiree Domingo-Foraste, M.D.
-
Amanda Frugoli, D.O
-
Michael Hochman, MD
-
Anna Mikhailovsky, M.D.
-
Naresh R Patel, M.D.
-
Sandhya T Patel, M.D.
-
Nhat Cong Vo, M.D.
Medicare Care Compare: Home health agency
- Listed as
- A Prime Home Health Services Inc
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- Proprietary
- Certified
- Aug 29, 2019
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2132814 | A Prime Home Health Services, Inc. | Certificate of waiver | Jun 27, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Home health agency certification: CCN 559058
- Legal name
- A PRIME HOME HEALTH SERVICES INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Aug 29, 2019
- Last certification
- Aug 29, 2019
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Aug 2, 2016 in CA
- Enrollment address
- 266 Mobil Ave
Ste 215
Camarillo, CA 93010-6336
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Carl C Villaluz |
5% Or Greater Direct Ownership Interest | Aug 2, 2016 | 60% |
| Corporate Officer |
Aug 2, 2016 | 60% | |
| Corporate Director |
Aug 2, 2016 | 60% | |
| W-2 Managing Employee |
Aug 2, 2016 | 60% | |
| Ivy Joyce Sagad |
W-2 Managing Employee |
Mar 1, 2021 | |
| Christopher a Villaluz |
5% Or Greater Direct Ownership Interest |
Jan 1, 2018 | 40% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170110003444 | CA | Part a Provider - Home Health Agency | 2668753468 | Practice locations: Camarillo, CA |
National Provider Directory
Locations
266 Mobil Ave
Ste 215
Camarillo, CA 93010
Phone (877) 332-6755
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
266 Mobil Ave Ste 215
Camarillo, CA 93010-6336
Mailing address
266 Mobil Ave Ste 215
Camarillo, CA 93010-6336
Phone (877) 332-6755
Other providers in Camarillo, CA
- 101 Foot and Ankle Inc.
- 1St Stop Urgent Care & Family Practice
- 1St Stop Urgent Care & Family Practice
- 360 Nutrition Consulting Inc
- A Team Nutrition, LLC
- A to B Transport, LLC
- A1 Speech Therapy, Inc.
- Teresa Elisenda Aagaard
- La Shaun Demor Aaron
All providers in Camarillo, CA · Home Health Agency in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.