Organization Active NPI

L.a. Home Healthcare, Inc

  • Home Health Agency
  • Columbus, OH
National Provider Identifier
1912213463
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
201022800817 Issued in OH
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

Updated by the provider on Apr 4, 2017

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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
CorporationProprietary
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, IncCCN 368403 · All quality measures
Ownership
Proprietary
Certified
Mar 6, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, 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
36D2027119La Home Healthcare, Inc6161 Busch Blvd, Ste 206, Columbus, OH 43229Certificate of waiverApr 19, 2028

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Liban Mohamed Individual 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 Individual 5% Or Greater Direct Ownership InterestAdministrator 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

Verify at the official NPI Registry.