Healthy Living at Home - Carson City LLC
Organization Active NPI Home Health Agency · Carson City, NV
NPI 1922597574 · NPPES record last updated Nov 20, 2023
Key facts
- NPI
- 1922597574
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- HEALTHY LIVING AT HOME - CARSON CITY LLC
- Practice address
- 1817 N Stewart St Ste 20&25
Carson City, NV 89706-2689 - Phone
- (775) 515-4203
- Fax
- (775) 204-2441
- NPI assigned
- May 8, 2018
- Organization subpart
- No
Authorized official
- Name
- Steve Murphy
- Title
- SVP, Finance
- Phone
- (619) 757-2700
Facilities with the same owner 96
Affiliated clinicians 94
-
Cheruba Abraham, M.D.
-
Phil M Aldrich, M.D.
-
Shaheen S Ali, M.D.
-
Teresa Angermann, DO
-
Samir S Bajwa, DO
-
Amy Marie Barats, APN
-
Tiffany R. Barnett, M.D.
-
Allison Dawn Basta, APRN
-
Edith Berejnaya, FNP-BC
-
Mark Thomas Brune, M.D.
-
Janice K Bryan, AON
-
Elena L Crandell, APRN
-
Julia Chrystal Dixon, APRN
-
Sara Douglas, NP
-
Bradley Ryan Duncan, APRN/RNFA
-
Kacey N. Durant, MD
-
Steven Lee Elliott, M.D.
-
Katrina Anne Fogel, PA.-C
-
Olivia Grace Franke, PA-C
Medicare Care Compare: Home health agency
- Listed as
- Mission Home Health of Carson City
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- Feb 5, 2019
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Home health agency certification: CCN 297249
- Legal name
- HEALTHY LIVING AT HOME - CARSON CITY LLC
- Doing business as
- MISSION HOME HEALTH OF CARSON CITY
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Feb 5, 2019
- Last certification
- Feb 5, 2019
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Apr 5, 2018 in NV
- Enrollment address
- 1817 N Stewart St
Ste 20&25
Carson City, NV 89706-2689
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Gregory J. Vislocky |
5% Or Greater Indirect Ownership Interest |
Oct 11, 2018 | 12% |
| Mission Healthcare Intermediate Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jul 12, 2021 | 60% |
| TVG Bolt Buyer, LLC |
5% Or Greater Indirect Ownership Interest | Jul 12, 2021 | 28.67% |
| Capricorn Healthcare & Special Opportunities II, LP |
5% Or Greater Indirect Ownership Interest | Jul 12, 2021 | 5.55% |
| MH Holdings Management Holdco LLC |
5% Or Greater Indirect Ownership Interest | Jul 12, 2021 | 12.88% |
| Vistria Fund III (Ft) LP |
5% Or Greater Indirect Ownership Interest | Jul 12, 2001 | 9.2% |
| HLH Carson City Holdings LLC |
5% Or Greater Direct Ownership Interest | Apr 18, 2018 | 100% |
| TVG MH Holdings III (Ft) LP |
5% Or Greater Indirect Ownership Interest | Jul 12, 2021 | 9.44% |
| TVG MH Intermediate Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jul 12, 2021 | 60% |
| HLH TVG Holdings, LLC |
5% Or Greater Indirect Ownership Interest | Oct 11, 2018 | 60% |
| TVG MH III (Ft) Blocker LLC |
5% Or Greater Indirect Ownership Interest | Jul 12, 2021 | 9.44% |
| Steve Murphy |
Corporate Officer |
Jun 5, 2023 | |
| Corporate Director |
Jun 5, 2023 | ||
| Operational/Managerial Control |
Jun 5, 2023 | ||
| Brian R Delamarter |
5% Or Greater Indirect Ownership Interest |
Oct 11, 2018 | 16.67% |
| D. D. & F. |
5% Or Greater Indirect Ownership Interest | Oct 11, 2018 | 40% |
| TVG MH Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jul 12, 2021 | 60% |
| Vistria Fund III LP |
5% Or Greater Indirect Ownership Interest | Jul 12, 2021 | 19.22% |
| Harold G Delamarter |
5% Or Greater Indirect Ownership Interest |
Oct 11, 2018 | 11.33% |
| HLH Opco LLC |
5% Or Greater Indirect Ownership Interest | Oct 11, 2018 | 60% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180716002251 | NV | Part a Provider - Home Health Agency | 1850648312 | Practice locations: Carson City, NV |
National Provider Directory
Locations
600 E William St
Ste 208
Carson City, NV 89701
Phone (775) 629-2502
1817 N Stewart St
Ste 2025
Carson City, NV 89706
Phone (775) 515-4203
1817 N Stewart St
Ste 35
Carson City, NV 89706
Phone (775) 515-4203
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
1817 N Stewart St Ste 20&25
Carson City, NV 89706-2689
Mailing address
2365 Northside Dr Ste 200
San Diego, CA 92108-2720
Phone (888) 871-0766
Other providers in Carson City, NV
- Heal Therapy of Nevada
- Healogics Specialty Physicians of Nevada-Johnson, PLLC
- Health Co
- Health Services Nevada LLC
- Healtherapy of Nevada
- Stephen Heape
- Hearing Care of Carson City, LTD
- Casey Heckman
- Aaron Carl Heide
- Shannon Heiderman
All providers in Carson City, NV · Home Health Agency in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.