NPIMap

Organization Active NPI

Premiere Angel Care Home Health LLC

  • Home Health Agency
  • Alice, TX
National Provider Identifier
1679813117
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
015568 Issued in TX
Legal business name
PREMIERE ANGEL CARE HOME HEALTH LLC
Practice address
3248 West Highway 44
Alice, TX 78332-9364
Phone
(361) 701-6465
NPI assigned
Feb 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Authorized official

Name
Marissa Benavides
Title
President
Phone
(361) 661-9701

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Home Health Agency 251E00000X 015568 TX Primary
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

3248 West Highway 44
Alice, TX 78332-9364

Mailing address

3248 West Highway 44
Alice, TX 78332-9364
Phone (361) 701-6465

Other names 1

  • Premiere Angel Care Home Health LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130724000827 TX Part A Provider - Home Health Agency 1658512280 Practice locations: Alice, TX

Home health agency certification: CCN 747917

Legal name
PREMIERE ANGEL CARE HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 26, 2013
Last certification
Nov 12, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Feb 18, 2013 in TX
Enrollment address
3248 Highway 44
Alice, TX 78332-7358

Care Compare: Home health agency

Medicare Care Compare
Listed as
Premiere Angel Care Home Health LLCCCN 747917 ยท All quality measures
Overall star rating
1 of 5
Ownership
Proprietary
Certified
Dec 26, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Premiere Angel Care Home Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Marissa Benavides Individual 5% Or Greater Direct Ownership Interest Feb 18, 2013 50%
Corporate DirectorBoard President/Treasurer Feb 18, 2013 50%
Armando Benavides Individual 5% Or Greater Direct Ownership InterestVice President/Secretary Feb 18, 2013 50%
Corporate DirectorVice President/Secretary Feb 18, 2013 50%
Monica Chapa Individual W-2 Managing EmployeeAdministrator/Director of Nursin Feb 18, 2013 50%
Irene Gonzalez Individual W-2 Managing EmployeeAlternate Adminstratoe/Alternate Feb 18, 2013 50%

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1361318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1679813117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3248 WEST HIGHWAY 44",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "783329364",
            "telephone_number": "361-701-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 WEST HIGHWAY 44",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "783329364",
            "telephone_number": "361-701-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE ANGEL CARE HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-20",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "BENAVIDES",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "361-661-9701"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "015568",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premiere Angel Care Home Health LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Premiere Angel Care Home Health LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Alice, TX

Sources for this page

Verify at the official NPI Registry.