NPIMap

Organization Active NPI

Avatar Home Health Care Agency, LLC

  • Community Based Hospice Care Agency
  • The Woodlands, TX
National Provider Identifier
1821387473
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
010674 Issued in TX
Legal business name
AVATAR HOME HEALTH CARE AGENCY, LLC
Practice address
25325 Borough Park Drive
Suite #100
The Woodlands, TX 77380
Phone
(281) 465-8220
Fax
(281) 298-7502
NPI assigned
Apr 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Authorized official

Name
Mr. Felix N Canabal
Title
Alt. Administrator
Phone
(281) 465-8220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 010674 TX Primary

Addresses

Primary practice location

25325 Borough Park Drive
Suite #100
The Woodlands, TX 77380

Mailing address

25325 Borough Park Drive
Suite #100
The Woodlands, TX 77380
Phone (281) 465-8220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110721000545 TX Part A Provider - Hospice 4082626858 Practice locations: The Woodlands, TX

Hospice certification: CCN 671692

Legal name
AVATAR HOME HEALTH CARE AGENCY, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 29, 2011
Last certification
Mar 22, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Apr 18, 2006 in TX
Enrollment address
25325 Brough Park Drive
Ste 100
The Woodlands, TX 77380

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Avatar Home Health Care Agency LLCCCN 671692 ยท All quality measures
Ownership
For-Profit
Certified
Nov 29, 2011
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Avatar Home Health Agency2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Felix Canabal Individual 5% Or Greater Direct Ownership Interest May 9, 2011
Corporate Director May 9, 2011
W-2 Managing Employee May 9, 2011
Gloria Acosta Individual W-2 Managing EmployeeAlternate Supervising Nurse Feb 14, 2022
Operational/Managerial ControlAlternate Supervising Nurse Feb 14, 2022
Richard Arguez Individual 5% Or Greater Direct Ownership Interest May 9, 2011
Corporate Director May 9, 2011
Priscilla C Arguez Individual 5% Or Greater Direct Ownership Interest May 9, 2011
Corporate Director May 9, 2011
Maria Canabal Individual 5% Or Greater Direct Ownership Interest May 9, 2011
Corporate Director May 9, 2011

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1821387473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25325 BOROUGH PARK DRIVE",
            "address_2": "SUITE #100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "77380",
            "telephone_number": "281-465-8220",
            "fax_number": "281-298-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25325 BOROUGH PARK DRIVE",
            "address_2": "SUITE #100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "77380",
            "telephone_number": "281-465-8220",
            "fax_number": "281-298-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVATAR HOME HEALTH CARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "CANABAL",
        "authorized_official_first_name": "FELIX",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "ALT. ADMINISTRATOR",
        "authorized_official_telephone_number": "281-465-8220",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "010674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.