Angleton Home Health Inc
Organization Active NPI Home Health Agency · Angleton, TX
NPI 1730182502 · NPPES record last updated Jun 14, 2024
Key facts
- NPI
- 1730182502
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 009583 (TX)
- Legal business name
- ANGLETON HOME HEALTH INC
- Practice address
- 1212 N Velasco St
Ste 200
Angleton, TX 77515-3090 - Phone
- (979) 848-0219
- Fax
- (979) 848-2025
- NPI assigned
- May 24, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Elva Gutierrez
- Title
- Administrator
- Phone
- (979) 848-0219
Medicare Care Compare: Home health agency
- Listed as
- Angleton Visiting Nurses
- Ownership
- Proprietary
- Certified
- Feb 15, 2002
- 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 |
|---|---|---|---|
| 45D0992511 | Angleton Visiting Nurses Inc | Certificate of waiver | Oct 17, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Home health agency certification: CCN 679109
- Legal name
- ANGLETON HOME HEALTH INC
- Doing business as
- ANGLETON VISITING NURSES
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Feb 15, 2002
- Last certification
- Aug 7, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Sep 20, 2001 in TX
- Enrollment address
- 1204 N Velasco St
Angleton, TX 77515-3095
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Mary Elva Elva Gutierrez |
5% Or Greater Direct Ownership Interest | Nov 5, 2004 | |
| Corporate Director | Jan 6, 2005 | ||
| W-2 Managing Employee | Nov 5, 2004 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050106000222 | TX | Part a Provider - Home Health Agency | 2567410533 | Practice locations: Angleton, TX |
National Provider Directory
Locations
1212 N Velasco St
Ste 200
Angleton, TX 77515
Phone (979) 848-0219
1204 N Velasco St
Ste 200
Angleton, TX 77515
2508 N Velasco St
Ste A
Angleton, TX 77515
Phone (979) 848-0219
1204 N Velasco St
Angleton, TX 77515
Phone (979) 848-0219
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 009583 | TX | Yes |
Addresses
Primary practice location
1212 N Velasco St
Ste 200
Angleton, TX 77515-3090
Mailing address
1204 N Velasco St Ste 200
Angleton, TX 77515-3095
Phone (979) 848-0219
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 148964301 | Medicaid | TX | |
| 001004547 | Other | TX | PHC PROVIDER NUMBER |
Other names
- ANGLETON VISITING NURSES
Other providers in Angleton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2024. 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.