NPIMap

Organization Active NPI

Intra Care Home Health Providers Inc

  • Home Health Agency
  • Los Angeles, CA
National Provider Identifier
1700871233
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
980001387 Issued in CA
Legal business name
INTRA CARE HOME HEALTH PROVIDERS INC
Practice address
4929 Wilshire Blvd
Suite 210
Los Angeles, CA 90010-3808
Phone
(323) 964-0884
Fax
(323) 857-7206
NPI assigned
Sep 12, 2005
Last updated
Nov 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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

Authorized official

Name
Ms. Dionalyn Ugbebor, RN,BSN
Title
Administrator
Phone
(323) 964-0884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 980001387 CA Primary

Addresses

Primary practice location

4929 Wilshire Blvd
Suite 210
Los Angeles, CA 90010-3808

Mailing address

4929 Wilshire Blvd
Suite 210
Los Angeles, CA 90010-3808
Phone (323) 964-0884

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030210000049 CA Part A Provider - Home Health Agency 5193634772 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700871233. Details of each certification follow.

Home health agency certification: CCN 058135

Legal name
INTRA CARE HOME HEALTH PROVIDERS INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 3, 2002
Last certification
Jan 28, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Dec 27, 2001 in CA
Enrollment address
4929 Wilshire Blvd
Ste 210
Los Angeles, CA 90010-3817
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Intra Care Home Health Providers, IncCCN 058135 · All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Oct 3, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0996713Intra Care Home Health Provider Inc4929 Wilshire Blvd Ste 210, Los Angeles, CA 90010Certificate of waiverDec 5, 2026

National Provider Directory

National Provider Directory

Locations

4727 Wilshire Blvd
#607
Los Angeles, CA 90010
Phone (323) 964-0884

4929 Wilshire Blvd
Ste 210
Los Angeles, CA 90010
Phone (323) 964-0884

5274 W Pico Blvd
Ste 214
Los Angeles, CA 90019
Phone (323) 934-5151

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Dionalyn C Ugbebor Individual 5% Or Greater Direct Ownership InterestOwner Dec 27, 2001 100%
Corporate OfficerCeo Dec 27, 2001 100%
Corporate DirectorPresident Dec 27, 2001 100%
W-2 Managing EmployeeAdministrator Dec 27, 2001 100%
Operational/Managerial ControlCeo/President/Administrator Dec 27, 2001 100%

Practitioners & affiliated clinicians

Affiliated clinicians 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541548800000",
    "number": "1700871233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4929 WILSHIRE BLVD",
            "address_2": "SUITE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103808",
            "telephone_number": "323-964-0884",
            "fax_number": "323-857-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4929 WILSHIRE BLVD",
            "address_2": "SUITE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103808",
            "telephone_number": "323-964-0884",
            "fax_number": "323-857-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTRA CARE HOME HEALTH PROVIDERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2018-11-07",
        "status": "A",
        "authorized_official_last_name": "UGBEBOR",
        "authorized_official_first_name": "DIONALYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-964-0884",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN,BSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.