Organization Active NPI

Ally at Home Inc

  • Home Health Agency
  • Lancaster, TX
National Provider Identifier
1740942838
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ALLY AT HOME INC
Practice address
3200 W Pleasant Run Rd Ste 404
Lancaster, TX 75146-1073
Phone
(903) 229-8203
NPI assigned
Oct 6, 2021
Last updated
Nov 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Authorized official

Name
Laverne Michelle Moore, RNNPI 1225340573
Title
Owner
Phone
(903) 229-8203

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3200 W Pleasant Run Rd Ste 404
Lancaster, TX 75146-1073

Mailing address

3200 W Pleasant Run Rd Ste 404
Lancaster, TX 75146-1073
Phone (903) 229-8203

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221116002488 TX Part A Provider - Home Health Agency 2365810728 Practice locations: Lancaster, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740942838. Details of each certification follow.

Home health agency certification: CCN 748127

Legal name
ALLY AT HOME INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 10, 2024
Last certification
May 29, 2024
Organization structure
CorporationProprietary
Incorporated
Sep 21, 2021 in TX
Enrollment address
3200 W Pleasant Run Rd
Ste 404
Lancaster, TX 75146-1073
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Ally at Home, Inc.CCN 748127 · All quality measures
Ownership
-
Certified
Jun 10, 2024
Medicare certification status
ActiveFrom the Provider of Services file

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
45D2260051Ally at Home, LLC3200 W Pleasant Run Rd Suite 404, Lancaster, TX 75146Certificate of waiverMay 12, 2028

National Provider Directory

National Provider Directory

Locations

3200 W Pleasant Run Rd
Ste 404
Lancaster, TX 75146
Phone (214) 600-2772

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Rita Jasso Individual 5% Or Greater Direct Ownership Interest Jan 14, 2022 25%
W-2 Managing Employee Jan 14, 2022
Glynis Blocker Individual 5% Or Greater Direct Ownership Interest Jan 14, 2022 25%
W-2 Managing Employee Jan 14, 2022
Karlo Fajardo Individual 5% Or Greater Direct Ownership Interest Jan 14, 2022 25%
W-2 Managing Employee Jan 14, 2022
Laverne Moore Individual 5% Or Greater Direct Ownership Interest Jan 14, 2022 25%
W-2 Managing Employee Jan 14, 2022

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1740942838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 W PLEASANT RUN RD STE 404",
            "city": "LANCASTER",
            "state": "TX",
            "postal_code": "751461073",
            "telephone_number": "903-229-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 W PLEASANT RUN RD STE 404",
            "city": "LANCASTER",
            "state": "TX",
            "postal_code": "751461073",
            "telephone_number": "903-229-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLY AT HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-06",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "LAVERNE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-229-8203",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, TX

Sources for this page

Verify at the official NPI Registry.