Organization Active NPI

A&B Home Health Inc

  • Home Health Agency
  • Davie, FL
National Provider Identifier
1710949649
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA299991828 Issued in FL
Legal business name
A&B HOME HEALTH INC
Practice address
4431 Davie Rd
Suite 119
Davie, FL 33314-3458
Phone
(954) 321-8681
Fax
(954) 321-8682
NPI assigned
Apr 5, 2006
Last updated
Dec 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Authorized official

Name
Mrs. Bettina S Toledo
Title
Administrator
Phone
(954) 321-8681

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA299991828 FL Primary

Addresses

Primary practice location

4431 Davie Rd
Suite 119
Davie, FL 33314-3458

Mailing address

4431 Davie Rd
Suite 119
Davie, FL 33314-3458
Phone (954) 321-8681

Other identifiers 2

IdentifierTypeStateIssuer
651038800MedicaidFL
690273179MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060308000066 FL Part A Provider - Home Health Agency 9436045143 Practice locations: Davie, FL
O20100615000642 FL Part A Provider - Home Health Agency 9436045143 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami Lakes, FL

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1710949649. Details of each certification follow.

Home health agency certification: CCN 108075

Legal name
A&B HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 15, 2004
Last certification
Apr 19, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Feb 21, 2003 in FL
Enrollment address
4431 Davie Rd
Ste 119
Davie, FL 33314-3458

Home health agency certification: CCN 109672

Legal name
A&B HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 28, 2011
Last certification
Jan 24, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Feb 21, 2003 in FL
Enrollment address
6169 Miami Lakes Drive East
Miami Lakes, FL 33014-2408

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
A & B Home Health IncCCN 108075 · All quality measures
Ownership
Proprietary
Certified
Jul 15, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

Care Compare: Home health agency

Medicare Care Compare
Listed as
A & B Home Health IncCCN 109672 · All quality measures
Ownership
Proprietary
Certified
Feb 28, 2011
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

Locations

4431 Davie Rd
Ste 119
Davie, FL 33314
Phone (954) 321-8681

6169 Miami Lakes Dr E
Miami Lakes, FL 33014
Phone (305) 819-6790

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Detorres Health LLC Organization, Miramar, FL Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Aug 18, 2020 50%
Asier Torres Individual 5% Or Greater Direct Ownership InterestPresident/ Board Member Nov 5, 2008 50%
5% Or Greater Mortgage InterestPresident/ Board Member Mar 7, 2008 50%
5% Or Greater Security InterestPresident/ Board Member Mar 7, 2008 50%
General Partnership InterestPresident/ Board Member Mar 7, 2008 50%
Corporate OfficerPresident/ Board Member Mar 7, 2008 50%
Corporate DirectorPresident/ Board Member Mar 7, 2008 50%
W-2 Managing Employee Mar 7, 2008
Operational/Managerial ControlPresident/ Board Member Mar 7, 2008 50%
5% Or Greater Direct Ownership InterestPresident, Board Member Nov 5, 2008 50%
5% Or Greater Mortgage InterestPresident, Board Member Nov 5, 2008 50%
5% Or Greater Security InterestPresident, Board Member Nov 5, 2008 50%
General Partnership InterestPresident, Board Member Nov 5, 2008 50%
Corporate OfficerPresident, Board Member Nov 5, 2008 50%
Corporate DirectorPresident, Board Member Nov 5, 2008 50%
W-2 Managing EmployeePresident, Board Member Nov 5, 2008
Operational/Managerial ControlPresident, Board Member Nov 5, 2008 50%
Maelys Brena Individual 5% Or Greater Indirect Ownership Interest Aug 18, 2020 50%
Corporate Officer Aug 18, 2020 50%
Corporate Director Aug 18, 2020 50%
5% Or Greater Direct Ownership InterestVice President, Board Member Aug 15, 2020 50%
5% Or Greater Mortgage InterestVice President, Board Member Aug 15, 2020 50%
5% Or Greater Security InterestVice President, Board Member Aug 15, 2020 50%
General Partnership InterestVice President, Board Member Aug 15, 2020 50%
Corporate OfficerVice President, Board Member Aug 15, 2020 50%
Corporate DirectorVice President, Board Member Aug 15, 2020 50%
W-2 Managing EmployeeVice President, Board Member Aug 15, 2020 50%
Operational/Managerial ControlVice President, Board Member Aug 15, 2020 50%

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1710949649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4431 DAVIE RD",
            "address_2": "SUITE 119",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143458",
            "telephone_number": "954-321-8681",
            "fax_number": "954-321-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4431 DAVIE RD",
            "address_2": "SUITE 119",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143458",
            "telephone_number": "954-321-8681",
            "fax_number": "954-321-8682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A&B HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "TOLEDO",
        "authorized_official_first_name": "BETTINA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-321-8681",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "HHA299991828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "651038800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690273179",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.