Organization Active NPI

Staff Assistance, Inc.

  • Home Health Agency
  • Covina, CA
National Provider Identifier
1851344717
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
980001303 Issued in CA
Legal business name
STAFF ASSISTANCE, INC.
Practice address
1126 N Grand Ave Ste 201
Covina, CA 91724-1549
Phone
(626) 915-5595
Fax
(626) 974-0136
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Authorized official

Name
Teresa Aulestia
Title
Administrator
Phone
(805) 371-9980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 980001303 CA Primary

Addresses

Primary practice location

1126 N Grand Ave Ste 201
Covina, CA 91724-1549

Mailing address

72 Moody CT Ste 100
Thousand Oaks, CA 91360-7426
Phone (805) 371-9980

Other identifiers 1

IdentifierTypeStateIssuer
HHA07292FMedicaidCA

Other names 1

  • ASSISTED HEALTHCARE SERVICES Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20020904000021 CA Part A Provider - Home Health Agency 8820905706 Practice locations: Covina, CA; Los Angeles, CA

Home health agency certification: CCN 058156

Legal name
STAFF ASSISTANCE, INC.
Doing business as
ASSISTED HEALTHCARE SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 23, 2002
Last certification
Dec 30, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 14, 1992 in CA
Enrollment address
1126 N Grand Ave
Ste 201
Covina, CA 91724-1551
HHA Branch

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: Home health agency

Medicare Care Compare
Listed as
Assisted Healthcare ServicesCCN 058156
Ownership
Proprietary
Certified
Oct 23, 2002
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
05D2321440Staff Assistance Inc1126 N Grand Ave Suite 201, Covina, CA 91724Certificate of waiverApr 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Assisted Home Recovery Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

1126 N Grand Ave
Ste 201
Covina, CA 91724
Phone (626) 915-5595

1900 W Garvey Ave S
Ste 210
West Covina, CA 91790

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.

NameRoleSinceShare
Elaine Denise Shelton Individual 5% Or Greater Direct Ownership Interest Jan 1, 1992 51%
Corporate OfficerCeo Jan 1, 1992 51%
W-2 Managing EmployeeCeo Jan 1, 1992 51%
Operational/Managerial ControlCeo Jan 1, 1992 51%
William Donley Individual 5% Or Greater Direct Ownership Interest Jan 1, 1992 49%
Corporate OfficerChairman of the Board Jan 1, 1992 49%

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1851344717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 MOODY CT STE 100",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913607426",
            "telephone_number": "805-371-9980",
            "fax_number": "805-371-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 N GRAND AVE STE 201",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917241549",
            "telephone_number": "626-915-5595",
            "fax_number": "626-974-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAFF ASSISTANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "AULESTIA",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "805-371-9980"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA07292F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASSISTED HEALTHCARE SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.