Angels of Mercy Home Health, LLC
Organization Active NPI Home Health Agency · Palmview, TX
NPI 1831101880 · NPPES record last updated Jan 4, 2023
Key facts
- NPI
- 1831101880
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 009584 (TX)
- Legal business name
- ANGELS OF MERCY HOME HEALTH, LLC
- Practice address
- 910 E Palma Vista Dr Ste a
Palmview, TX 78572-2048 - Phone
- (956) 583-9995
- Fax
- (956) 583-1305
- NPI assigned
- Aug 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Eva C Aguayo, LVN
- Title
- Alternate Administrator
- Phone
- (956) 583-9995
Medicare Care Compare: Home health agency
- Listed as
- Angels of Mercy Home Health LLC
- Ownership
- Proprietary
- Certified
- Apr 29, 2004
- Medicare certification status
- Active
- Services
- Nursing
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D1021543 | Angels of Mercy Home Health | Certificate of waiver | Jan 25, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Home health agency certification: CCN 679466
- Legal name
- ANGELS OF MERCY HOME HEALTH LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 29, 2004
- Last certification
- Feb 13, 2020
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Enrollment address
- 910 E Palma Vista Dr
Ste a
Palmview, TX 78572-2048
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Eva Aguayo |
W-2 Managing Employee |
Jan 1, 2008 | |
| Elia Canales |
5% Or Greater Direct Ownership Interest |
Dec 1, 2016 | 100% |
| Corporate Officer |
Jan 1, 2017 | 100% | |
| Corporate Director | Apr 29, 2004 | 50% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080328000671 | TX | Part a Provider - Home Health Agency | 5395846927 | Practice locations: Palmview, TX |
National Provider Directory
Locations
1000 E Expressway 83
Ste 2
La Joya, TX 78560
Phone (956) 583-9995
910 E Palma Vista Dr
Ste A
Palmview, TX 78572
Phone (956) 583-9995
910 E Palma Vista Dr
Palmview, TX 78572
Phone (956) 583-9995
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 009584 | TX | Yes |
| Personal Care Attendant |
3747P1801X | |||
| Respite Care | 385H00000X |
Addresses
Primary practice location
910 E Palma Vista Dr Ste a
Palmview, TX 78572-2048
Mailing address
910 E Palma Vista Dr Ste a
Palmview, TX 78572-2048
Phone (956) 583-9995
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009584 | Other | TX | HCSSA LICENSE NUMBER |
| CL8644 | Other | TX | MEDICARE PART B |
| 001015440 | Other | TX | PHC |
| 001015441 | Other | TX | CBA |
| 1730053-01 | Medicaid | TX |
Other names
- DBA Angels of Mercy Home Health
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Palmview | ||
| CONNECT URL | angelsofmercyhh@yahoo.com |
Other providers in Palmview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.