NPIMap

Organization Active NPI

Lifelink Health Providers, Inc.

  • Home Health Agency
  • Glendora, CA
National Provider Identifier
1790980969
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LIFELINK HEALTH PROVIDERS, INC.
Practice address
211 W Foothill Blvd Ste a
Glendora, CA 91741-3357
Phone
(626) 387-9650
Fax
(626) 387-9651
NPI assigned
Jun 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Authorized official

Name
Raymond Rommel S Sison
Title
President
Phone
(626) 387-9650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

211 W Foothill Blvd Ste a
Glendora, CA 91741-3357

Mailing address

211 W Foothill Blvd Ste a
Glendora, CA 91741-3357
Phone (626) 387-9650

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070905000634 CA Part A Provider - Home Health Agency 0648363721 Practice locations: Glendora, CA

Home health agency certification: CCN 059067

Legal name
LIFELINK HEALTH PROVIDERS, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 4, 2009
Last certification
Apr 5, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jan 13, 2016 in CA
Enrollment address
211 W Foothill Blvd
Ste a
Glendora, CA 91741-3357

Care Compare: Home health agency

Medicare Care Compare
Listed as
Lifelink Health Providers, IncCCN 059067
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
May 4, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
05D1081118Lifelink Health Providers Inc211 W Foothill Blvd Ste a, Glendora, CA 91741Certificate of waiverMar 9, 2028
05D2127949Lifelink Health Providers211 W Foothill Blvd Ste B, Glendora, CA 91741Certificate of waiverMar 21, 2027

National Provider Directory

National Provider Directory

Locations

211 W Foothill Blvd
Glendora, CA 91741

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Rosario M Valenciano-Sison Individual 5% Or Greater Direct Ownership Interest Oct 21, 2011 50%
Corporate OfficerSecretary/Cfo Oct 21, 2011 50%
Corporate DirectorSecretary/Cfo/Board Member Oct 21, 2011 50%
W-2 Managing EmployeeAdmin. Designee/Dir Bus Ops Oct 21, 2011 50%
Raymond Rommel S Sison Individual 5% Or Greater Direct Ownership InterestAdministrator Sep 4, 2007 50%
Corporate OfficerPresident/Board Memeber Jan 22, 2007 50%
Corporate DirectorPresident/Board Member Jan 22, 2007 50%
W-2 Managing EmployeeAdministrator Jan 22, 2007 50%
Adelaine Cailipan Individual W-2 Managing Employee Apr 5, 2013

Practitioners & affiliated clinicians

Affiliated clinicians 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520294400000",
    "number": "1790980969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W FOOTHILL BLVD STE A",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413357",
            "telephone_number": "626-387-9650",
            "fax_number": "626-387-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W FOOTHILL BLVD STE A",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413357",
            "telephone_number": "626-387-9650",
            "fax_number": "626-387-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINK HEALTH PROVIDERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2018-03-06",
        "status": "A",
        "authorized_official_last_name": "SISON",
        "authorized_official_first_name": "RAYMOND ROMMEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-387-9650"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.