Active NPI
Mubarak LLC
Doing business as Aging Gracefully Home Health
- Home Health Agency
- Richmond, TX
National Provider Identifier
1780212803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- MUBARAK LLC
- Doing business as
- Aging Gracefully Home Health
- Practice address
- 8627 Crescent Spur Dr
Richmond, TX 77406-3611 - Phone
- (713) 505-7775
- Fax
- (713) 730-3632
- NPI assigned
- Apr 1, 2020
- Last updated
- Apr 28, 2023
- Organization subpart
- Yes
- Parent organization
- MUBARAK LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amin Abjani
- Title
- Cfo
- Phone
- (281) 925-7621
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary | ||
| Home Infusion Agency | 251F00000X | |||
| Nursing Care Agency | 251J00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Respite Care | 385H00000X | |||
| Child Mental Illness Respite Care | 385HR2055X | |||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | |||
| Child Physical Disabilities Respite Care | 385HR2065X |
Addresses
Primary practice location
8627 Crescent Spur Dr
Richmond, TX 77406-3611
Mailing address
8627 Crescent Spur Dr
Richmond, TX 77406-3611
Other names 1
- Aging Gracefully Home Health
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200701003492 | TX | Part A Provider - Home Health Agency | 7113340548 | Practice locations: Richmond, TX |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1780212803. Details of each certification follow.
Home health agency certification: CCN 748043
- Legal name
- MUBARAK LLC
- Doing business as
- AGING GRACEFULLY HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- May 27, 2022
- Last certification
- Oct 8, 2021
- Organization structure
- LLC
- Incorporated
- Sep 25, 2019 in TX
- Enrollment address
- 8627 Crescent Spur Dr
Richmond, TX 77406-3611
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Aging Gracefully Home Health
- Overall star rating
- Ownership
- -
- Certified
- May 27, 2022
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Part of
- Mubarak LLC
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Rosemin Premji | 5% Or Greater Direct Ownership Interest | Sep 25, 2019 | 100% |
| Operational/Managerial Control | May 8, 2020 | 100% | |
| Mubarak LLC | 5% Or Greater Direct Ownership Interest | Sep 25, 2019 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 3
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": "1585699200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1682640000000",
"number": "1780212803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8627 CRESCENT SPUR DR",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774063611",
"fax_number": "713-730-3632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8627 CRESCENT SPUR DR",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774063611",
"telephone_number": "713-505-7775",
"fax_number": "713-730-3632"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MUBARAK LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MUBARAK LLC",
"enumeration_date": "2020-04-01",
"last_updated": "2023-04-28",
"certification_date": "2023-04-28",
"status": "A",
"authorized_official_last_name": "ABJANI",
"authorized_official_first_name": "AMIN",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "281-925-7621"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "251F00000X",
"taxonomy_group": "",
"desc": "Home Infusion",
"state": null,
"license": null,
"primary": false
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2055X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Mental Illness, Child",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2065X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Physical Disabilities, Child",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Aging Gracefully Home Health",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Aging Gracefully Home Health",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Richmond, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.