Organization Active NPI

Advanced Care Home Health, LLC

  • Home Health Agency
  • Houston, TX
National Provider Identifier
1972141778
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ADVANCED CARE HOME HEALTH, LLC
Practice address
950 Echo LN # 200-23
Houston, TX 77024-2756
Phone
(713) 239-1141
Fax
(713) 583-5315
NPI assigned
Dec 12, 2019
Last updated
May 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Authorized official

Name
Juan Carlos Mazorra
Title
Administrator
Phone
(713) 239-1141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

950 Echo LN # 200-23
Houston, TX 77024-2756

Mailing address

950 Echo LN # 200-23
Houston, TX 77024-2756
Phone (713) 239-1141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210921002663 TX Part A Provider - Home Health Agency 0345647137 Practice locations: Houston, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972141778. Details of each certification follow.

Home health agency certification: CCN 748006

Legal name
ADVANCED CARE HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 21, 2020
Last certification
Dec 21, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Nov 21, 2019 in TX
Enrollment address
950 Echo LN
# 200-23
Houston, TX 77024-2756

Care Compare: Home health agency

Medicare Care Compare
Listed as
Advanced Care Home Health, LLC.CCN 748006 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Dec 21, 2020
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
45D2199852Advanced Care Home Health, LLC950 Echo LN Ste 200-23, Houston, TX 77024Certificate of waiverNov 10, 2026

National Provider Directory

National Provider Directory

Locations

950 Echo Ln
#20023
Houston, TX 77024
Phone (713) 239-1141

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Juan Mazorra Individual 5% Or Greater Direct Ownership Interest Nov 22, 2019 37.5%
Santiago Franco Individual 5% Or Greater Direct Ownership InterestOffice Manager Nov 22, 2019 10%
W-2 Managing EmployeeOffice Manager Jun 1, 2020 10%
Clelia Mazorra Individual 5% Or Greater Direct Ownership Interest Nov 22, 2019 15%
Robert Gholson Individual 5% Or Greater Direct Ownership InterestAlternate Admin Nov 22, 2019 37.5%

Practitioners & affiliated clinicians

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": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1972141778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 ECHO LN # 200-23",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242756",
            "telephone_number": "713-239-1141",
            "fax_number": "713-583-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 ECHO LN # 200-23",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242756",
            "telephone_number": "713-239-1141",
            "fax_number": "713-583-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CARE HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2023-05-04",
        "certification_date": "2023-04-19",
        "status": "A",
        "authorized_official_last_name": "MAZORRA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "713-239-1141"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.