Active NPI
L.a. Home Healthcare, Inc
- Home Health Agency
- Columbus, OH
National Provider Identifier
1912213463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 201022800817
- Legal business name
- L.A. HOME HEALTHCARE, INC
- Practice address
- 6161 Busch Blvd
Suite 206
Columbus, OH 43229-2508 - Phone
- (614) 840-9300
- Fax
- (614) 840-9301
- NPI assigned
- Aug 22, 2010
- 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
- Mr. Liban A Mohamed
- Title
- Owner
- Phone
- (614) 840-9300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 201022800817 | OH | Primary |
Addresses
Primary practice location
6161 Busch Blvd
Suite 206
Columbus, OH 43229-2508
Mailing address
6161 Busch Blvd
Suite 206
Columbus, OH 43229-2508
Phone (614) 840-9300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101215000224 | OH | Part A Provider - Home Health Agency | 2668669706 | Practice locations: Columbus, OH |
Home health agency certification: CCN 368403
- Legal name
- L.A. HOME HEALTHCARE, INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Mar 6, 2012
- Last certification
- Dec 21, 2017
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Aug 20, 2010 in OH
- Enrollment address
- 6161 Busch Blvd
Suite 206
Columbus, OH 43229
Care Compare: Home health agency
Medicare Care Compare- Listed as
- L a Home Healthcare, Inc
- Ownership
- Proprietary
- Certified
- Mar 6, 2012
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, 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 |
|---|---|---|---|
| 36D2027119 | La Home Healthcare, Inc | Certificate of waiver | Apr 19, 2028 |
National Provider Directory
National Provider DirectoryLocations
6161 Busch Blvd
Ste 206
Columbus, OH 43229
Phone (614) 840-9300
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 |
|---|---|---|---|
| Liban Mohamed | 5% Or Greater Direct Ownership Interest | Mar 1, 2017 | 50% |
| General Partnership Interest | Nov 2, 2010 | ||
| Corporate Director | Nov 2, 2010 | ||
| W-2 Managing Employee | Nov 2, 2010 | ||
| Abdiaziz Dirie | 5% Or Greater Direct Ownership Interest | Apr 13, 2015 | 50% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282435200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1491264000000",
"number": "1912213463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6161 BUSCH BLVD",
"address_2": "SUITE 206",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432292508",
"telephone_number": "614-840-9300",
"fax_number": "614-840-9301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6161 BUSCH BLVD",
"address_2": "SUITE 206",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432292508",
"telephone_number": "614-840-9300",
"fax_number": "614-840-9301"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "L.A. HOME HEALTHCARE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2010-08-22",
"last_updated": "2017-04-04",
"status": "A",
"authorized_official_last_name": "MOHAMED",
"authorized_official_first_name": "LIBAN",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "614-840-9300",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "OH",
"license": "201022800817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.