Organization Active NPI

Great Valley Home Health LLC

Doing business as Great Valley Home Health

  • Home Health Agency
  • Tracy, CA
National Provider Identifier
1902448368
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GREAT VALLEY HOME HEALTH LLC
Doing business as
Great Valley Home Health
Practice address
2730 Naglee Rd Ste 200
Tracy, CA 95304-7309
Phone
(209) 229-8454
NPI assigned
Oct 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Authorized official

Name
Mr. Ferdinand Lee
Title
President
Phone
(209) 229-8454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

2730 Naglee Rd Ste 200
Tracy, CA 95304-7309

Mailing address

2730 Naglee Rd Ste 200
Tracy, CA 95304-7309
Phone (209) 229-8454

Other names 1

  • GREAT VALLEY HOME HEALTH Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200206000111 CA Part A Provider - Home Health Agency 7618303868 Practice locations: Tracy, CA

Home health agency certification: CCN 559260

Legal name
GREAT VALLEY HOME HEALTH LLC
Doing business as
GREAT VALLEY HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 8, 2020
Last certification
Dec 8, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
2730 Naglee Rd
Ste 200
Tracy, CA 95304-7309

Care Compare: Home health agency

Medicare Care Compare
Listed as
Great Valley Home HealthCCN 559260 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Dec 8, 2020
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
05D2181717Great Valley Home Health LLC2730 Naglee Road Suite 200, Tracy, CA 95304Certificate of waiverApr 8, 2028

National Provider Directory

National Provider Directory

Locations

2730 Naglee Rd
#200
Tracy, CA 95304
Phone (209) 229-8454

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
Noreen Fajardo Individual 5% Or Greater Direct Ownership InterestCfo/Owner Oct 1, 2025 50%
Corporate OfficerCfo/Owner Oct 1, 2025 50%
Corporate DirectorCfo/Owner Oct 1, 2025 50%
W-2 Managing EmployeeCfo/Owner Oct 1, 2025 50%
Ferdinand Lee Individual 5% Or Greater Direct Ownership InterestPresident/Ceo Oct 1, 2025 50%
Corporate Officer Oct 1, 2025 50%
Corporate Director Oct 1, 2025 50%
W-2 Managing EmployeeAd;DPCS Oct 1, 2025 50%

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1902448368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 NAGLEE RD STE 200",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953047309",
            "telephone_number": "209-229-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 NAGLEE RD STE 200",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953047309",
            "telephone_number": "209-229-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT VALLEY HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "FERDINAND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-229-8454",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREAT VALLEY HOME HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tracy, CA

Sources for this page

Verify at the official NPI Registry.