Organization Active NPI

Inbalance Home Health, LLC

  • Home Health Agency
  • San Tan Valley, AZ
National Provider Identifier
1962955708
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
5392 Issued in AZ
Legal business name
INBALANCE HOME HEALTH, LLC
Practice address
36397 N Gantzel Rd Ste 101
San Tan Valley, AZ 85140-7336
Phone
(480) 494-6622
Fax
(480) 930-4030
NPI assigned
Jul 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Authorized official

Name
Donny Taylor
Title
Member
Phone
(903) 539-5603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 5392 AZ Primary

Addresses

Primary practice location

36397 N Gantzel Rd Ste 101
San Tan Valley, AZ 85140-7336

Mailing address

36397 N Gantzel Rd
San Tan Valley, AZ 85140-7335
Phone (480) 494-6622

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170419001276 AZ Part A Provider - Home Health Agency 5395021745 Practice locations: San Tan Valley, AZ

Home health agency certification: CCN 037472

Legal name
INBALANCE HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 17, 2017
Last certification
Mar 30, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
36397 N Gantzel Rd
Ste 101
San Tan Valley, AZ 85140-7336

Care Compare: Home health agency

Medicare Care Compare
Listed as
Inbalance Home Health, LLCCCN 037472 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Nov 17, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory

Locations

36397 N Gantzel Rd
Ste 101
San Tan Valley, AZ 85140
Phone (480) 494-6622

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
Ryan K Vance Individual 5% Or Greater Direct Ownership InterestCo-Owner Oct 26, 2016 33.3%
Corporate Officer Oct 26, 2016 33.3%
Corporate Director Jul 27, 2016 33%
Stephen L Montierth Individual 5% Or Greater Direct Ownership InterestCo-Owner Oct 26, 2016 33.3%
Donny C Taylor Individual 5% Or Greater Direct Ownership InterestOwner Oct 26, 2016 33.3%
Corporate Officer Jul 27, 2016 33%
Operational/Managerial ControlOwner Jul 27, 2016 33.3%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1962955708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36397 N GANTZEL RD",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407335",
            "telephone_number": "480-494-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36397 N GANTZEL RD STE 101",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407336",
            "telephone_number": "480-494-6622",
            "fax_number": "480-930-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INBALANCE HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-28",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "DONNY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "903-539-5603"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "5392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Tan Valley, AZ

Sources for this page

Verify at the official NPI Registry.