Organization Active NPI

Angelical Home Health, Inc.

  • Home Health Agency
  • La Joya, TX
National Provider Identifier
1922057652
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
010100 Issued in TX
Legal business name
ANGELICAL HOME HEALTH, INC.
Practice address
504 Lake Point St
La Joya, TX 78560-4021
Phone
(956) 581-1251
Fax
(956) 581-4859
NPI assigned
May 9, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Ms. Blanca Lamar Gonzalez, R.N./CFO/OWNER
Title
Cfo/Owner
Phone
(956) 581-1251

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Angelical Home Health, Inc.CCN 677881
Ownership
Proprietary
Certified
Mar 30, 2006
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
45D1042585Angelical Home Health, Inc504 Lake Point Street, La Joya, TX 78560Certificate of waiverJul 4, 2027

Medicare participation

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

Home health agency certification: CCN 677881

Medicare enrollment files
Legal name
ANGELICAL HOME HEALTH, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 30, 2006
Last certification
Dec 7, 2017
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Aug 4, 2005 in TX
Enrollment address
504 Lake Point St
La Joya, TX 78560-4021

All disclosed owners & managing parties 2

Medicare enrollment files

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

NameRoleSinceShare
Jayne Melendez Individual W-2 Managing Employee Jan 28, 2015
Blanca Gonzalez Individual 5% Or Greater Direct Ownership Interest Apr 27, 2007
Corporate Director Apr 27, 2007
W-2 Managing Employee Apr 27, 2007

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20080110000464 TX Part a Provider - Home Health Agency 9830102086 Practice locations: La Joya, TX

National Provider Directory

National Provider Directory

Locations

730 E Expressway 83
Ste 9
La Joya, TX 78560

208 Diamond St
Unit 7
La Joya, TX 78560
Phone (956) 581-1251

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 010100 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

504 Lake Point St
La Joya, TX 78560-4021

Mailing address

504 Lake Point St
La Joya, TX 78560-4021
Phone (956) 581-1251

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
677881OtherTXMEDICARE PROVIDER NUMBER

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 3, 2021.

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1922057652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 LAKE POINT ST",
            "city": "LA JOYA",
            "state": "TX",
            "postal_code": "785604021",
            "telephone_number": "956-581-1251",
            "fax_number": "956-581-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 LAKE POINT ST",
            "city": "LA JOYA",
            "state": "TX",
            "postal_code": "785604021",
            "telephone_number": "956-581-1251",
            "fax_number": "956-581-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELICAL HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "BLANCA",
        "authorized_official_middle_name": "LAMAR",
        "authorized_official_title_or_position": "CFO/OWNER",
        "authorized_official_telephone_number": "956-581-1251",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N./CFO/OWNER"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "010100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "677881",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Joya, TX

Sources for this page

Verify at the official NPI Registry.