Active NPI
Staff Assistance, Inc.
- Home Health Agency
- Covina, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 980001303
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HHA07292F | Medicaid | CA |
Other names 1
- ASSISTED HEALTHCARE SERVICES
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- Incorporated
- Apr 14, 1992 in CA
- Enrollment address
- 1126 N Grand Ave
Ste 201
Covina, CA 91724-1551
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 Services
- Ownership
- Proprietary
- Certified
- Oct 23, 2002
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2321440 | Staff Assistance Inc | Certificate of waiver | Apr 2, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Assisted Home Recovery Inc
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Mission Hills, CA
- NPI 1356396410
-
- Home Health Agency
- Thousand Oaks, CA
- NPI 1508819020
-
- Home Health Agency
- Ventura, CA
- NPI 1790738748
-
- Point of Service
- Ventura, CA
- NPI 1982932554
-
- Home Health Agency
- Scottsdale, AZ
- NPI 1821266057
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Elaine Denise Shelton | 5% Or Greater Direct Ownership Interest | Jan 1, 1992 | 51% |
| Corporate Officer | Jan 1, 1992 | 51% | |
| W-2 Managing Employee | Jan 1, 1992 | 51% | |
| Operational/Managerial Control | Jan 1, 1992 | 51% | |
| William Donley | 5% Or Greater Direct Ownership Interest | Jan 1, 1992 | 49% |
| Corporate Officer | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.