Warm Springs Home Health, Inc.

Organization Active NPI Home Health Agency · Fremont, CA

NPI 1790701175 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1790701175
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
Legal business name
WARM SPRINGS HOME HEALTH, INC.
Practice address
54 Whitney PL
Fremont, CA 94539-7662
Phone
(510) 490-6988
Fax
(510) 490-9588
NPI assigned
Jul 15, 2006
Organization subpart
No

Authorized official

Name
Mrs. Alphie E De Guzman
Title
Governing Body/Ceo
Phone
(510) 490-6988

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 22

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Home health agency

Listed as
Warm Springs Home Health, Inc CCN 058425
Overall star rating
★★★★★ 4.5 of 5
Ownership
Proprietary
Certified
Nov 8, 2007
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1056668Warm Springs Home Health Inc
54 Whitney Place, Fremont, CA 94539
Certificate of waiverJul 20, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Home health agency certification: CCN 058425

Legal name
WARM SPRINGS HOME HEALTH, INC.
Doing business as
WARM SPRINGS HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 8, 2007
Last certification
Aug 23, 2019
Ownership / control type
Proprietary
Organization structure
Corporation · Proprietary
Incorporated
Nov 21, 2003 in CA
Enrollment address
54 Whitney PL
Fremont, CA 94539-7662

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
Carlito G Liamzon
Individual
W-2 Managing Employee
Director of Patient Care Service
Aug 30, 2012
Operational/Managerial Control
Director of Patient Care Service
Aug 30, 2012 100%
Mario I de Guzman
Individual
Corporate Officer
Cfo
Nov 21, 2003 100%
Alphie E de Guzman
Individual
5% Or Greater Direct Ownership Interest
President/Ceo
Nov 21, 2003 100%
Corporate Officer
President/Ceo
Nov 21, 2003 100%
Corporate Director
President/Ceo
Nov 21, 2003 100%
W-2 Managing Employee
Administrator
Dec 10, 2007 100%
Operational/Managerial Control
Administrator
Dec 10, 2007 100%
Phillip F Tse
Individual
W-2 Managing Employee
Medical Director
Feb 18, 2013 100%
Operational/Managerial Control
Medical Director
Feb 18, 2013 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20060818000485 CA Part a Provider - Home Health Agency 7012910722 Practice locations: Fremont, CA

National Provider Directory

Locations

54 Whitney Pl
Fremont, CA 94539
Phone (510) 490-6988

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Yes

Addresses

Primary practice location

54 Whitney PL
Fremont, CA 94539-7662

Mailing address

54 Whitney PL
Fremont, CA 94539-7662
Phone (510) 490-6988

Other providers in Fremont, CA

All providers in Fremont, CA · Home Health Agency in California

Sources for this page

Verify at the official NPI Registry.