Acacia Home Health, Inc
Organization Active NPI Home Health Agency · Yuma, AZ
NPI 1679977979 · NPPES record last updated Mar 3, 2015
Key facts
- NPI
- 1679977979
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- ACACIA HOME HEALTH, INC
- Practice address
- 250 W 24TH St
Suite C Suite E
Yuma, AZ 85364-8574 - Phone
- (928) 726-9163
- Fax
- (928) 726-1040
- NPI assigned
- Oct 15, 2014
- Organization subpart
- No
Authorized official
- Name
- Mrs. Silvia Garcia
- Title
- President
- Phone
- (928) 726-9163
Affiliated clinicians 8
-
Georgina A Adjei, MD
-
Adil M Baig, M.D.
-
Matthew G Bishop, MD
-
Dawn Jannice Domenech, A-GNP-C
-
Julia L Luevanos, FNP
-
George E Reusser, MD
-
Christina Urrutia, FNP
Medicare Care Compare: Home health agency
- Listed as
- Acacia Home Health, Inc.
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- Oct 12, 2009
- 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 |
|---|---|---|---|
| 03D2086682 | Acacia Home Health Care Inc | Certificate of waiver | Nov 6, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Home health agency certification: CCN 037269
- Legal name
- ACACIA HOME HEALTH INC
- Doing business as
- ACACIA HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Oct 12, 2009
- Last certification
- Sep 16, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Sep 16, 2014 in AZ
- Enrollment address
- 103 E 24TH St
Yuma, AZ 85364-8544
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Jesus E Garcia |
5% Or Greater Direct Ownership Interest |
Sep 10, 2020 | 50% |
| Silvia Garcia |
5% Or Greater Direct Ownership Interest | Sep 10, 2020 | 50% |
| Corporate Officer | Aug 1, 2015 | 40% | |
| Corporate Director |
Aug 1, 2015 | 40% | |
| Operational/Managerial Control |
Oct 13, 2014 | 50% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141204002413 | AZ | Part a Provider - Home Health Agency | 1254653017 | Practice locations: Yuma, AZ |
National Provider Directory
Locations
250 W 24th St
Ste C
Yuma, AZ 85364
Phone (928) 726-9163
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
250 W 24TH St
Suite C Suite E
Yuma, AZ 85364-8574
Mailing address
250 W 24TH St
Suite C & Suite E
Yuma, AZ 85364-8574
Phone (928) 726-9163
NPI Registry JSON
{
"created_epoch": "1413331200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1425340800000",
"number": "1679977979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 W 24TH ST",
"address_2": "SUITE C & SUITE E",
"city": "YUMA",
"state": "AZ",
"postal_code": "853648574",
"telephone_number": "928-726-9163",
"fax_number": "928-726-1040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 W 24TH ST",
"address_2": "SUITE C SUITE E",
"city": "YUMA",
"state": "AZ",
"postal_code": "853648574",
"telephone_number": "928-726-9163",
"fax_number": "928-726-1040"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACACIA HOME HEALTH, INC",
"organizational_subpart": "NO",
"enumeration_date": "2014-10-15",
"last_updated": "2015-03-03",
"status": "A",
"authorized_official_last_name": "GARCIA",
"authorized_official_first_name": "SILVIA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "928-726-9163",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2015. 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.