OrganizationActive
Black Mountain, LLC
NPI 1396110219 · Home Health Agency · San Mateo, CA
Black Mountain, LLC is a Home Health Agency organization in San Mateo, CA (NPI 1396110219).
Provider details
- NPI number
- 1396110219
- Entity type
- Organization
- Primary specialty
- Home Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Jake Caruso, Managing Director(650) 785-2800
Specialties & taxonomies
Agencies
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
177 Bovet Rd
Suite 130
San Mateo, CA 94402-3116
Phone: (650) 785-2800
Fax: (650) 785-2801
Street-level locationGet directions
Mailing address
Po Box 72
Burlingame, CA 94011-0072
Other names (DBA / former)
- Doing business as
- Interim Healthcare
Registry dates
- Enumerated
- 2015-12-03
- Last updated
- 2015-12-03
Frequently asked questions
- What is Black Mountain, LLC's NPI number?
- Black Mountain, LLC's National Provider Identifier (NPI) is 1396110219, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Black Mountain, LLC?
- Black Mountain, LLC is classified in the NPPES registry as Home Health Agency (Agencies).
- Where is Black Mountain, LLC located?
- Black Mountain, LLC's practice location on file with NPPES is 177 Bovet Rd, San Mateo, CA 94402-3116.
- What is Black Mountain, LLC's phone number?
- The practice phone number listed in the NPPES registry for Black Mountain, LLC is (650) 785-2800.
- Who is the authorized official for Black Mountain, LLC?
- The authorized official listed on Black Mountain, LLC's NPPES record is Jake Caruso, Managing Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Black Mountain, LLC's NPI active?
- Yes — Black Mountain, LLC's NPI (1396110219) is active in the NPPES registry as of the last update on 2015-12-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.