NPIMap

Organization Active NPI

Avatar Home Health Care Agency, LLC

  • Home Health Agency
  • The Woodlands, TX
National Provider Identifier
1710937677
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
010674 Issued in TX
Legal business name
AVATAR HOME HEALTH CARE AGENCY, LLC
Practice address
25325 Borough Park Drive
Suite #100
The Woodlands, TX 77380
Phone
(281) 465-8220
Fax
(281) 298-7502
NPI assigned
May 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Mr. Felix Nicomedes Canabal
Title
Alt. Administrator
Phone
(281) 465-8220

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 010674 TX Primary
Community Based Hospice Care Agency 251G00000X

Addresses

Primary practice location

25325 Borough Park Drive
Suite #100
The Woodlands, TX 77380

Mailing address

25325 Borough Park Drive
Suite #100
The Woodlands, TX 77380
Phone (281) 465-8220

Other identifiers 3

IdentifierTypeStateIssuer
001016077MedicaidTX
001016078MedicaidTX
1867061-01MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060616000055 TX Part A Provider - Home Health Agency 4082626858 Practice locations: The Woodlands, TX

Home health agency certification: CCN 679618

Legal name
AVATAR HOME HEALTH CARE AGENCY, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 13, 2007
Last certification
Mar 22, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Apr 10, 2006 in TX
Enrollment address
25325 Borough Park Drive
Suite #100
The Woodlands, TX 77380

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Avatar Home Health Care Agency LLCCCN 679618 ยท All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Apr 13, 2007
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
Avatar Home Health Agency2 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.

Locations

25325 Borough Park Dr
Ste 100
The Woodlands, TX 77380
Phone (281) 465-8220

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Felix Canabal Individual 5% Or Greater Direct Ownership InterestAlt. Administraotr, Cfo Apr 18, 2006 25%
Corporate Director Apr 18, 2006
Gloria Acosta Individual W-2 Managing EmployeeAlternate Supervising Nurse Oct 11, 2021
Operational/Managerial ControlAlternate Supervising Nurse Oct 11, 2021
Richard Arguez Individual 5% Or Greater Direct Ownership InterestOwner May 24, 2006 25%
Priscilla C Arguez Individual 5% Or Greater Direct Ownership InterestAdministrator, Director of Nursing May 24, 2006 25%
Corporate Director May 24, 2006
W-2 Managing Employee May 24, 2006
Maria Canabal Individual 5% Or Greater Direct Ownership InterestOwner May 24, 2006 25%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1710937677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25325 BOROUGH PARK DRIVE",
            "address_2": "SUITE #100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "77380",
            "telephone_number": "281-465-8220",
            "fax_number": "281-298-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25325 BOROUGH PARK DRIVE",
            "address_2": "SUITE #100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "77380",
            "telephone_number": "281-465-8220",
            "fax_number": "281-298-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVATAR HOME HEALTH CARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "CANABAL",
        "authorized_official_first_name": "FELIX",
        "authorized_official_middle_name": "NICOMEDES",
        "authorized_official_title_or_position": "ALT. ADMINISTRATOR",
        "authorized_official_telephone_number": "281-465-8220",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "010674",
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001016077",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001016078",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1867061-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.