Organization Active NPI

High Desert Community Home Health Inc

  • Home Health Agency
  • Barstow, CA
National Provider Identifier
1912529074
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
HIGH DESERT COMMUNITY HOME HEALTH INC
Practice address
222 E Main St Ste 216
Barstow, CA 92311-2366
Phone
(909) 582-0515
NPI assigned
May 12, 2020
Last updated
May 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Authorized official

Name
Celestine Amajoyi
Title
Owner
Phone
(909) 961-9379

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

222 E Main St Ste 216
Barstow, CA 92311-2366

Mailing address

5050 Juneau CT
Rancho Cucamonga, CA 91739-2653
Phone (909) 961-9379

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210608002359 CA Part A Provider - Home Health Agency 1557761871 Practice locations: Barstow, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912529074. Details of each certification follow.

Home health agency certification: CCN 757270

Legal name
HIGH DESERT COMMUNITY HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 4, 2022
Last certification
Jul 22, 2022
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jan 10, 2020 in CA
Enrollment address
222 E Main St
Ste 216
Barstow, CA 92311-2366

Care Compare: Home health agency

Medicare Care Compare
Listed as
High Desert Community Home Health IncCCN 757270 · All quality measures
Ownership
Proprietary
Certified
Aug 4, 2022
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Celestine Amajoyi Individual Corporate Officer Jan 10, 2020 10%
Corporate DirectorOwner/Secretary Jan 10, 2020 10%
W-2 Managing EmployeeOwner/Secretary Jan 10, 2020 10%
Operational/Managerial ControlOwner Secretary Jan 10, 2020 10%
Callistus Amajoyi Individual 5% Or Greater Direct Ownership Interest Jan 10, 2020 40%
Corporate OfficerOwner/Ceo/President Jan 10, 2020 40%
Corporate DirectorOwner/Ceo/President Jan 10, 2020 40%
W-2 Managing EmployeeOwner/Ceo/President Jan 10, 2020 40%
Operational/Managerial ControlOwner/Ceo/President Jan 10, 2020
Barbara C Amajoyi Individual 5% Or Greater Direct Ownership Interest Jan 10, 2020 40%
Corporate OfficerOwner/Vice President Jan 10, 2020 40%
Corporate DirectorOwnership/Vice President Jan 10, 2020 40%
W-2 Managing EmployeeOwner/Vice President Jan 10, 2020 40%
Operational/Managerial ControlOwner/Vice President Jan 10, 2020 40%

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

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": "1589241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589241600000",
    "number": "1912529074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 JUNEAU CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392653",
            "telephone_number": "909-961-9379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E MAIN ST STE 216",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923112366",
            "telephone_number": "909-582-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH DESERT COMMUNITY HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A",
        "authorized_official_last_name": "AMAJOYI",
        "authorized_official_first_name": "CELESTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-961-9379"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barstow, CA

Sources for this page

Verify at the official NPI Registry.