Acclaim Home Health Services Inc
Organization Active NPI Home Health Agency · Mason, OH
NPI 1720022569 · NPPES record last updated Nov 17, 2020
Key facts
- NPI
- 1720022569
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 1628158 (OH)
- Legal business name
- ACCLAIM HOME HEALTH SERVICES INC
- Practice address
- 7566 Central Parke Blvd
Mason, OH 45040-6816 - Phone
- (513) 336-6133
- Fax
- (513) 336-6134
- NPI assigned
- Jun 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Phetmany Brower
- Title
- President
- Phone
- (513) 336-6133
Medicare Care Compare: Home health agency
- Listed as
- Acclaim Home Health Services, Inc
- Ownership
- Proprietary
- Certified
- Dec 4, 1995
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D0912127 | Acclaim Home Health Services Inc | Certificate of waiver | Feb 22, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Home health agency certification: CCN 367668
- Legal name
- ACCLAIM HOME HEALTH SERVICES INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 4, 1995
- Last certification
- Sep 27, 2018
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Jun 9, 2006 in OH
- Enrollment address
- 7566 Central Parke Blvd
Mason, OH 45040-6816
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Lehang Truong |
5% Or Greater Direct Ownership Interest | Jun 9, 2006 | 31% |
| Corporate Director |
Jun 9, 2007 | 31% | |
| Boutsy Bouahom |
5% Or Greater Direct Ownership Interest | Jun 9, 2006 | 31% |
| Corporate Director |
Jun 9, 2006 | 31% | |
| W-2 Managing Employee | Jan 1, 2009 | ||
| Phetmany Brower |
5% Or Greater Direct Ownership Interest |
Jun 9, 2006 | 38% |
| Corporate Officer |
Jun 9, 2006 | 100% | |
| Corporate Director |
Jun 6, 2006 | 38% | |
| W-2 Managing Employee |
Jun 9, 2006 | 100% | |
| Operational/Managerial Control |
Jun 9, 2006 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061003000264 | OH | Part a Provider - Home Health Agency | 1951306562 | Practice locations: Mason, OH |
National Provider Directory
Locations
7566 Central Parke Blvd
Mason, OH 45040
Phone (513) 336-6133
4770 Duke Dr
Ste 195
Mason, OH 45040
Phone (513) 336-6133
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1628158 | OH | Yes |
Addresses
Primary practice location
7566 Central Parke Blvd
Mason, OH 45040-6816
Mailing address
7566 Central Parke Blvd
Mason, OH 45040-6816
Phone (513) 336-6133
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2703186 | Medicaid | OH |
Other providers in Mason, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2020. 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.